Dr. Danila on Considerations for Treatment Selection in Nonmetastatic CRPC

Daniel C. Danila, MD, medical oncologist, Memorial Sloan Kettering Cancer Center, discusses factors to consider when selecting a treatment option for patients with nonmetastatic castration-resistant prostate cancer (CRPC).

Comorbidities play a significant role in informing treatment decisions for this patient population, according to Danila. Currently, a significant amount of data are available on enzalutamide (Xtandi), due to its long use in clinical practice. This agent would be a good treatment option if access to imaging to not available, Danila notes. However, those treated with darolutamide (Nubeqa) may experience less fatigue, making it a good choice for elderly patients, Danila explains.

Other treatment considerations include drug–drug interactions and adverse effects, such as cardiovascular risk factors, Danila adds. It is difficult to generalize for all patients, although enzalutamide would be the standard choice if there is doubt about patient histology or limited access to imaging, Danila concludes.