ESMO 2024: darolutamide plus ADT in P... - Advanced Prostate...

Advanced Prostate Cancer

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ESMO 2024: darolutamide plus ADT in Patients with mHSPC from ARANOTE Trial

Maxone73 profile image
7 Replies

My take here is: patients receiving darolutamide and ADT had a 46% reduction in the risk of disease progression or death compared to those on ADT alone (hazard ratio [HR] 0.54). Secondary endpoints also favored the darolutamide group, including delays in the time to castration-resistant prostate cancer (HR 0.40) and time to PSA progression (HR 0.31). Impressively, 62.6% of patients in the darolutamide group achieved undetectable PSA levels, versus 18.5% in the placebo group.

Safety profiles between the two groups were comparable, with a slightly lower discontinuation rate due to adverse events in the darolutamide group (6.1% vs. 9.0%). Common side effects associated with androgen receptor inhibitors were similar or less frequent in the darolutamide group, with fatigue reported less often.

Some numbers:

- at 24 months, 70.2 % was the probability of patients using daro +adt to be still radiologically progression free, compared to 52% of placebo arm

- at 36 months the median of castrate resistant patients in daro + adt arm was still not reached (far from being reached) compared to 16.8 months of the placebo + adt arm

- PSA < 0.2 ng/mL at any time during treatment occurred in 62.6% of daro +adt patients compared to 18.5% for placebo +adt

urotoday.com/conference-hig...

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Maxone73
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JohnInTheMiddle profile image
JohnInTheMiddle

Hi Max - fantastic summary of this key paper from ESMO. Can you clarify what say 24 months or 36 months means? Does that mean if I have to stop my doublet therapy and switch over to the new regime, that I might get say 24 months median life expectancy? On top of whatever I did already? 😃

Maxone73 profile image
Maxone73 in reply toJohnInTheMiddle

Rephrase please :-D

JohnInTheMiddle profile image
JohnInTheMiddle in reply toMaxone73

I reworded the original. See if that helps 😃

Maxone73 profile image
Maxone73 in reply toJohnInTheMiddle

well, when I say x months usually they mean from the date of randomization. “Eligible patients had mHSPC by conventional imaging, an ECOG performance status of 0–2, and started ADT ≤ 12 weeks” so I suppose they were all de novo diagnose. Or you mean that switching back and forth from therapies would reset the clock?? 😀

JohnInTheMiddle profile image
JohnInTheMiddle in reply toMaxone73

My apologies - I was thinking of another report that concerned therapies after resistance. Step by step... super thanks for your reports.

PresidentOfBelgium profile image
PresidentOfBelgium

awesome !!!

Thanks for sharing 👍👍👍

Samrecan profile image
Samrecan

Thanks for the update Max!

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