Dr. Heath on Developments in Nonmetastatic CRPC

Elisabeth I. Heath, MD, FACP, associate center director of Translational Sciences, lead of the Genitourinary Oncology Multidisciplinary Team, medical director of the Infusion Center, and director of Prostate Cancer Research at Barbara Ann Karmanos Cancer Institute, and professor of oncology at Wayne State University School of Medicine, discusses developments in nonmetastatic castration-resistant prostate cancer (CRPC).

Nonmetastatic CRPC is defined by a rising prostate-specific antigen (PSA) in men who are on androgen deprivation therapy, says Heath. Despite this, there is no evidence of metastasis on standard imaging. The inclination for men with rising PSA, which can indicate clinical progression, is to treat. Now, providers have the option to treat with apalutamide (Erleada), enzalutamide (Xtandi), or darolutamide (Nubeqa).

All 3 agents were approved based on data that showed an improvement in metastasis-free survival (MFS), which is a newer endpoint that is now recognized by the FDA, says Heath. MFS is a new nuance in how drugs will be developed in this space, concludes Heath.