Dr Grimm on Unmet Needs After Progression to mCRPC Following ARPI Plus Chemo

Marc-Oliver Grimm, MD, professor, chairman, Department of Urology, Jena University Hospital, discusses the unmet needs for patients who progress to metastatic castration-resistant prostate cancer (mCRPC) following treatment with an androgen receptor pathway inhibitor (ARPI), androgen deprivation therapy (ADT), and chemotherapy in the hormone-sensitive setting. He also highlights future steps of research following a post-hoc analysis of 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 ADT and docetaxel compared with those who received placebo plus ADT and docetaxel.

The analysis, which was presented at the 2024 ASCO Annual Meeting, revealed that darolutamide plus ADT and docetaxel increased overall survival compared with placebo plus ADT and docetaxel, and this regimen also delayed the time to progression to mCRPC. Following progression, patients treated with the darolutamide regimen had similar survival outcomes irrespective of subsequent therapy selection. However, patients who received the placebo regimen experienced prolonged survival when subsequent treatment included an ARPI vs non-ARPI therapies, which were primarily chemotherapy.

Grimm notes that results from the post-hoc analysis highlight a persisting need for more effective treatment options for patients who progress to mCRPC following treatment with an ARPI and chemotherapy. Additional analysis of the ARASENS trial is ongoing.