Apalutamide, darolutamide and enzalutamide in nonmetastatic castration-resistant prostate cancer: a meta-analysis

Future Oncol. 2021 May;17(14):1811-1823. doi: 10.2217/fon-2020-1104. Epub 2021 Feb 5.

Abstract

Aim: Comparison of the efficacy/safety/health-related quality of life of apalutamide, enzalutamide and darolutamide in Phase III clinical trials involving patients with nonmetastatic castration-resistant prostate cancer was performed. Materials & methods: Relevant studies were identified by searching PubMed as well as conference abstracts reporting updated overall survival. Three pivotal trials were identified, SPARTAN (apalutamide), PROSPER (enzalutamide) and ARAMIS (darolutamide), and form the basis of this analysis. Results: All three drugs significantly prolonged metastasis-free survival, prostate-specific antigen response and overall survival versus placebo, and were generally well tolerated. Conclusion: Drug selection will likely be influenced by tolerability/safety and other factors, such as the propensity for drug-drug interactions and the presence of comorbidities, that affect the risk-benefit balance in individual patients.

Keywords: androgen-receptor antagonist; androgen-receptor inhibitor; apalutamide; darolutamide; enzalutamide; nonmetastatic castration-resistant prostate cancer.

Publication types

  • Comparative Study
  • Meta-Analysis

MeSH terms

  • Benzamides / administration & dosage*
  • Benzamides / adverse effects
  • Benzamides / pharmacokinetics
  • Clinical Trials, Phase III as Topic
  • Disease-Free Survival
  • Drug Interactions
  • Humans
  • Kallikreins / blood
  • Kaplan-Meier Estimate
  • Male
  • Nitriles / administration & dosage*
  • Nitriles / adverse effects
  • Nitriles / pharmacokinetics
  • Phenylthiohydantoin / administration & dosage*
  • Phenylthiohydantoin / adverse effects
  • Phenylthiohydantoin / pharmacokinetics
  • Prostate-Specific Antigen / blood
  • Prostatic Neoplasms, Castration-Resistant / blood
  • Prostatic Neoplasms, Castration-Resistant / diagnosis
  • Prostatic Neoplasms, Castration-Resistant / drug therapy*
  • Prostatic Neoplasms, Castration-Resistant / mortality
  • Pyrazoles / administration & dosage*
  • Pyrazoles / adverse effects
  • Pyrazoles / pharmacokinetics
  • Quality of Life
  • Thiohydantoins / administration & dosage*
  • Thiohydantoins / adverse effects
  • Thiohydantoins / pharmacokinetics
  • Time Factors

Substances

  • Benzamides
  • Nitriles
  • Pyrazoles
  • Thiohydantoins
  • apalutamide
  • darolutamide
  • Phenylthiohydantoin
  • enzalutamide
  • KLK3 protein, human
  • Kallikreins
  • Prostate-Specific Antigen