Dr Morgans on the Clinical Significance of Data From the ARACOG Trial in Prostate Cancer

“When we have a better understanding of the effects of different treatments on cognitive function, we are able, as clinicians, to provide information to the best of our ability to patients so that they can try to sort through their decision between this androgen receptor pathway inhibitor [ARPI] and that ARPI and find the one that makes the most sense for them.”

Alicia Morgans, MD, MPH, a genitourinary medical oncologist and the medical director of the Survivorship Program at Dana-Farber Cancer Institute, as well as an associate professor of medicine at Harvard Medical School, discussed the clinical significance of data from the phase 2 ARACOG trial (NCT04335682) which evaluated the cognitive effects of enzalutamide (Xtandi) vs darolutamide (Nubeqa) in prostate cancer.

Patients enter consultations with unique goals, expectations, and personal priorities that shape how they evaluate available treatment options, Morgans began. For some individuals, the primary consideration is selecting the therapy most likely to control their disease or extend survival, she said. For others, equal or greater importance may be placed on understanding how treatment will affect daily functioning, independence, cognitive abilities, and overall quality of life, she continued. In reality, most patients seek a balance between these competing considerations, weighing the potential benefits of therapy against its impact on their physical, emotional, and cognitive well-being, she said.

Research examining cognitive outcomes associated with ARPIs can therefore provide valuable information for shared decision-making, Morgans said. As evidence emerges regarding differences in the cognitive effects of individual therapies, clinicians can better counsel patients on the potential trade-offs associated with each option, she added. This allows patients to make more informed choices that align with their personal values, treatment goals, and lifestyle priorities, she concluded.