Sequential therapy with darolutamide in patients with non‐metastatic castration‐resistant prostate cancer resistant to enzalutamide or apalutamide

Abstract Enzalutamide, apalutamide, and darolutamide are currently recommended for patients with non‐metastatic castration‐resistant prostate cancer (nmCRPC), but cross‐resistance of androgen receptor‐axis‐targeted therapies (ARAT) occurs. Because darolutamide has a distinct chemical structure to ot...

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Main Authors: Saizo Fujmoto, Kazutoshi Fujita, Mitsuhisa Nishimoto, Mamoru Hamaguchi, Ken Kuwahara, Mamoru Hashimoto, Shogo Adomi, Takafumi Minami, Masahiro Nozawa, Kazuhiro Yoshimura, Hirotsugu Uemura
Format: Article
Language:English
Published: Wiley 2023-02-01
Series:Cancer Medicine
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Online Access:https://doi.org/10.1002/cam4.5189
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author Saizo Fujmoto
Kazutoshi Fujita
Mitsuhisa Nishimoto
Mamoru Hamaguchi
Ken Kuwahara
Mamoru Hashimoto
Shogo Adomi
Takafumi Minami
Masahiro Nozawa
Kazuhiro Yoshimura
Hirotsugu Uemura
author_facet Saizo Fujmoto
Kazutoshi Fujita
Mitsuhisa Nishimoto
Mamoru Hamaguchi
Ken Kuwahara
Mamoru Hashimoto
Shogo Adomi
Takafumi Minami
Masahiro Nozawa
Kazuhiro Yoshimura
Hirotsugu Uemura
author_sort Saizo Fujmoto
collection DOAJ
description Abstract Enzalutamide, apalutamide, and darolutamide are currently recommended for patients with non‐metastatic castration‐resistant prostate cancer (nmCRPC), but cross‐resistance of androgen receptor‐axis‐targeted therapies (ARAT) occurs. Because darolutamide has a distinct chemical structure to other non‐steroidal antiandrogens, it may be effective for nmCRPC patients resistant to enzalutamide or apalutamide. We retrospectively evaluated the efficacy of switching to darolutamide in patients with nmCRPC. We included nine nmCRPC patients who experienced biochemical progression on enzalutamide or apalutamide and were switched over to darolutamide. Five patients (55.5%) had a PSA response >50% decline after starting darolutamide, with an average of 73% PSA decline. Median progression‐free survival was 6 months. In conclusion, an ARAT switch from enzalutamide or apalutamide to darolutamide might be effective for nmCRPC. Although the validation in a large‐scale cohort is necessary, the switch to darolutamide could be a promising therapeutic option after the progression of 1st line ARAT in nmCRPC patients.
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spelling doaj-art-f9ff1f67dce24f7fabefde0baaee780d2024-11-25T07:56:32ZengWileyCancer Medicine2045-76342023-02-011233176317910.1002/cam4.5189Sequential therapy with darolutamide in patients with non‐metastatic castration‐resistant prostate cancer resistant to enzalutamide or apalutamideSaizo Fujmoto0Kazutoshi Fujita1Mitsuhisa Nishimoto2Mamoru Hamaguchi3Ken Kuwahara4Mamoru Hashimoto5Shogo Adomi6Takafumi Minami7Masahiro Nozawa8Kazuhiro Yoshimura9Hirotsugu Uemura10Department of Urology Kindai University Faculty of Medicine Osakasayama Osaka JapanDepartment of Urology Kindai University Faculty of Medicine Osakasayama Osaka JapanDepartment of Urology Kindai University Faculty of Medicine Osakasayama Osaka JapanDepartment of Urology, Mimihara General Hospital, Sakai Osaka JapanDepartment of Urology Kindai University Faculty of Medicine Osakasayama Osaka JapanDepartment of Urology Kindai University Faculty of Medicine Osakasayama Osaka JapanDepartment of Urology Kindai University Faculty of Medicine Osakasayama Osaka JapanDepartment of Urology Kindai University Faculty of Medicine Osakasayama Osaka JapanDepartment of Urology Kindai University Faculty of Medicine Osakasayama Osaka JapanDepartment of Urology Kindai University Faculty of Medicine Osakasayama Osaka JapanDepartment of Urology Kindai University Faculty of Medicine Osakasayama Osaka JapanAbstract Enzalutamide, apalutamide, and darolutamide are currently recommended for patients with non‐metastatic castration‐resistant prostate cancer (nmCRPC), but cross‐resistance of androgen receptor‐axis‐targeted therapies (ARAT) occurs. Because darolutamide has a distinct chemical structure to other non‐steroidal antiandrogens, it may be effective for nmCRPC patients resistant to enzalutamide or apalutamide. We retrospectively evaluated the efficacy of switching to darolutamide in patients with nmCRPC. We included nine nmCRPC patients who experienced biochemical progression on enzalutamide or apalutamide and were switched over to darolutamide. Five patients (55.5%) had a PSA response >50% decline after starting darolutamide, with an average of 73% PSA decline. Median progression‐free survival was 6 months. In conclusion, an ARAT switch from enzalutamide or apalutamide to darolutamide might be effective for nmCRPC. Although the validation in a large‐scale cohort is necessary, the switch to darolutamide could be a promising therapeutic option after the progression of 1st line ARAT in nmCRPC patients.https://doi.org/10.1002/cam4.5189apalutamideARATdarolutamideenzalutamidenmCRPCprostate cancer
spellingShingle Saizo Fujmoto
Kazutoshi Fujita
Mitsuhisa Nishimoto
Mamoru Hamaguchi
Ken Kuwahara
Mamoru Hashimoto
Shogo Adomi
Takafumi Minami
Masahiro Nozawa
Kazuhiro Yoshimura
Hirotsugu Uemura
Sequential therapy with darolutamide in patients with non‐metastatic castration‐resistant prostate cancer resistant to enzalutamide or apalutamide
Cancer Medicine
apalutamide
ARAT
darolutamide
enzalutamide
nmCRPC
prostate cancer
title Sequential therapy with darolutamide in patients with non‐metastatic castration‐resistant prostate cancer resistant to enzalutamide or apalutamide
title_full Sequential therapy with darolutamide in patients with non‐metastatic castration‐resistant prostate cancer resistant to enzalutamide or apalutamide
title_fullStr Sequential therapy with darolutamide in patients with non‐metastatic castration‐resistant prostate cancer resistant to enzalutamide or apalutamide
title_full_unstemmed Sequential therapy with darolutamide in patients with non‐metastatic castration‐resistant prostate cancer resistant to enzalutamide or apalutamide
title_short Sequential therapy with darolutamide in patients with non‐metastatic castration‐resistant prostate cancer resistant to enzalutamide or apalutamide
title_sort sequential therapy with darolutamide in patients with non metastatic castration resistant prostate cancer resistant to enzalutamide or apalutamide
topic apalutamide
ARAT
darolutamide
enzalutamide
nmCRPC
prostate cancer
url https://doi.org/10.1002/cam4.5189
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