Dr. Choudhury on Clinical Trials of Interest in Nonmetastatic CRPC

Atish D. Choudhury, MD, PhD, co-director of the Prostate Cancer Center and a senior physician with Dana-Farber Cancer Institute, as well as an instructor in medicine at Harvard Medical School, discusses clinical trials of interest examining different agents, such as darolutamide (Nubeqa), enzalutamide (Xtandi), and apalutamide (Erleada) in patients with nonmetastatic castration-resistant prostate cancer (CRPC).

Several trials are examining antiandrogen agents in the context of high-risk localized disease, in both the neoadjuvant and adjuvant settings, Choudhury explains. For example, in the phase 3 PROTEUS trial, investigators are examining neoadjuvant and adjuvant apalutamide. Additionally, the phase 3 ENZARAD trial is examining enzalutamide in combination with androgen deprivation therapy and radiation for those with localized disease. In the same setting, the phase 3 ATLAS trial is examining apalutamide and the upcoming DASL-HiCAP trial will assess darolutamide, says Choudhury.

Most of the nonmetastatic CRPC space is comprised of patients who experience local recurrence, adds Choudhury. As such, if a patient receives more aggressive and effective treatments for localized disease early on, then they might be able to avoid the need for the use of these agents down the line, explains Choudhury. Ultimately, if this happens, more patients will be cured and the field will have less patients with nonmetastatic CRPC in the future, concludes Choudhury.