Therapies for Some With Prostate Cancer Focuses on Reducing Side Effects

Newer treatments for metastatic hormone-sensitive prostate cancer like Nubeqa (darolutamide) are being developed to potentially reduce side effects like cognitive impairment and fatigue, an expert said.

CURE® sat down with Dr. Fred Saad, director of prostate cancer research at Montreal Cancer Institute and full professor in the department of surgery at the Université de Montréal, on-site at the 2024 ESMO Congress to learn more about what Nubeqa is and how it may differ from other available treatment options for metastatic hormone-sensitive prostate cancer.

At the meeting, Saad presented findings from the phase 3 ARANOTE trial, which included patients with metastatic hormone-sensitive prostate cancer. Saad and his colleagues aimed to assess the efficacy and safety of Nubeqa plus androgen-deprivation therapy (hormone therapy to reduce testosterone levels) compared with placebo plus androgen-deprivation therapy.

Findings from the trial demonstrated that Nubeqa plus androgen-deprivation therapy significantly improved radiological progression-free survival (PFS; time patients live without their disease worsening or spreading) versus placebo plus androgen-deprivation therapy. This benefit was also seen in patients with high- and low-volume metastatic hormone-sensitive prostate cancer. Treatment with Nubeqa plus androgen-deprivation therapy was associated with a low incidence of treatment-emergent side effects, with a lower rate of treatment discontinuations from treatment-emergent side effects when adding Nubeqa (6.1% versus 9%).

Transcript:

[Nubeqa] is an androgen receptor inhibitor, which has a distinct molecular structure compared to apalutamide (Erleada) and enzalutamide (Xtandi) that are already established in the field.

What we developed with this medication is to try to have as little penetration of the drug into the brain to try to reduce the risks of cognitive impairment, fatigue and other issues. And also address the issue in the minority of patients who might be at risk of seizures. So this drug seems to be safe in patients even at risk of seizures. And all the trials using [Nubeqa] did not exclude patients with a seizure history or at risk of seizures.

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