Dr. Shore on Unique Challenges in Nonmetastatic CRPC

Neal D. Shore, MD, FACS, medical director of the Carolina Urologic Research Center, discusses unique challenges in nonmetastatic castration-resistant prostate cancer (CRPC).

In clinical trials, survival is used to determine an agent’s utility in nonmetastatic CRPC, explains Shore.

This is largely due to the fact that patients with nonmetastatic disease are often asymptomatic, regardless of tumor burden, says Shore. Moreover, these patients do not typically have a high tumor burden and instead have microscopic disease.

Although chronic androgen deprivation therapy use may lead to adverse effects (AEs), rising prostate-specific antigen and suppressed testosterone levels remain the main concerns in this patient population, Shore explains.

At the 2020 ASCO Virtual Scientific Program, data from the final analysis of the phase 3 ARAMIS trial showed that darolutamide (Nubeqa) significantly improved metastasis-free survival and overall survival without inducing significant AEs compared with placebo, concludes Shore.