Dr Grimm on Post-Progression OS After Darolutamide Plus ADT/Docetaxel in mHSPC

Marc-Oliver Grimm, MD, professor, chairman, Department of Urology, Jena University Hospital, discusses findings from a post-hoc analysis from the phase 3 ARASENS trial (NCT02799602). The analysis sought to evaluate post-progression survival in patients with metastatic hormone-sensitive prostate cancer (mHSPC) who received darolutamide (Nubeqa) in combination with androgen deprivation therapy (ADT) and docetaxel compared with those who received placebo plus ADT and docetaxel.

Grimm emphasizes the benefits of the triplet combination, particularly for younger patients. He noted that patients receiving the triplet therapy demonstrated prolonged survival in the mHSPC state and were generally associated with improved quality of life and minimal pain progression. This suggests a significant advantage in maintaining patients in the mHSPC state for an extended period, he says.

The analysis revealed that darolutamide plus ADT and docetaxel not only increased overall survival compared with placebo plus ADT and docetaxel, but the triplet also delayed the time to progression to metastatic castration-resistant prostate cancer (mCRPC). Additionally, patients treated with the darolutamide regimen had similar survival outcomes with all post-progression therapies, irrespective of treatment with another androgen receptor (AR) pathway inhibitor or chemotherapy. Conversely, patients receiving the placebo regimen experienced faster progression to mCRPC, and subsequent treatment with an AR pathway inhibitor improved survival vs non–AR pathway inhibitor therapies, which were primarily chemotherapy.

Grimm also highlights that although the triplet therapy offered significant initial benefits, there is a critical need for new treatment modalities for patients who progress after receiving chemotherapy and radical prostatectomy. This underscores the importance of ongoing research to develop new therapeutic strategies for patients with mHSPC post-progression, particularly for those who have exhausted standard treatment options.