Dr. Penson on Maintaining QoL With AR Inhibitors in Nonmetastatic CRPC

David F. Penson, MD, MPH, MMHC, chair, Department of Urology, and Paul V. Hamilton, MD and Virginia E. Howd Chair, Urologic Oncology, at Vanderbilt University Medical Center, discusses the importance of maintaining quality of life (QoL) for patients treated with androgen-receptor inhibitors in nonmetastatic castration-resistant prostate cancer (CRPC).

In 2018, enzalutamide (Xtandi) and apalutamide (Erleada) were FDA approved for the treatment of men with nonmetastatic CRPC. Darolutamide (Nubeqa) received approval for the same patient population in July 2019.

Though these agents appear to be [similar in efficacy], toxicity differences may guide treatment selection, explains Penson.

For example, enzalutamide is associated with fatigue while apalutamide may cause a rash, says Penson. Patients who experience these adverse events may switch to another agent.

Once the optimal drug is identified, the patient’s QoL will improve and their response will likely be better than if they received androgen deprivation therapy alone, concludes Penson.