Decisions and dilemmas in non-metastatic castration-resistant prostate cancer management

Med Oncol. 2022 May 13;39(7):107. doi: 10.1007/s12032-022-01743-7.

Abstract

Non-metastatic castration-resistant prostate cancer (nmCRPC) indicates a condition characterized by the progression of the prostate-specific antigen without radiographic evidence of distant metastasis on conventional imaging during androgen deprivation therapy (ADT). Recently, 3 phase III trials have shown that the addition of next-generation androgen-receptor inhibitors (ARIs) apalutamide, darolutamide, and enzalutamide to ADT allows patients with high-risk nmCRPC to delay the appearance of metastasis and to obtain long-term clinical benefits. However, the lack of head-to head comparison makes it difficult to choose one among these agents. We reviewed the literature and explained the rationale of the possible therapeutic choices. In any case, the availability of novel ARIs means that patients with nmCRPC have now a new effective treatment option that provides them a renewed hope.

Keywords: Apalutamide; Darolutamide; Enzalutamide; Non-metastatic castration-resistant prostate cancer (nmCRPC).

Publication types

  • Review

MeSH terms

  • Androgen Antagonists / therapeutic use
  • Androgen Receptor Antagonists / therapeutic use
  • Androgens
  • Humans
  • Male
  • Prostatic Neoplasms, Castration-Resistant* / drug therapy
  • Prostatic Neoplasms, Castration-Resistant* / pathology
  • Treatment Outcome

Substances

  • Androgen Antagonists
  • Androgen Receptor Antagonists
  • Androgens