Carolina Urologic Research Center/Genesis Care, Myrtle Beach, SC, USA.
Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA.
Oncologist. 2024 Mar 4;29(3):235-243. doi: 10.1093/oncolo/oyad254.
In the ARASENS trial (NCT02799602), darolutamide in combination with androgen-deprivation therapy (ADT) and docetaxel significantly reduced the risk of death by 32.5% (HR, 0.68; 95% CI, 0.57-0.80; P < .0001) compared with placebo plus ADT with docetaxel in patients with metastatic hormone-sensitive prostate cancer (mHSPC). We present efficacy and safety of darolutamide versus placebo in Black patients from ARASENS.
Patients with mHSPC were randomized 1:1 to darolutamide 600 mg or placebo twice daily in combination with ADT and docetaxel. The primary endpoint was overall survival. Key secondary endpoints included time to castration-resistant prostate cancer (CRPC) and safety.
In ARASENS, 54 Black patients received darolutamide (n = 26) or placebo (n = 28) plus ADT and docetaxel. In Black patients, overall survival favored darolutamide versus placebo (median, not reached vs. 38.7 months; stratified HR, 0.41; 95% CI, 0.17-1.02), with 4-year survival rates of 62% versus 41%. The darolutamide group also had longer time to CRPC compared with the placebo group (median, not reached vs .12.6 months; HR, 0.09; 95% CI, 0.02-0.30). The safety profile of darolutamide in Black patients was consistent with that observed for the overall ARASENS population (grade 3/4 treatment-emergent adverse events, TEAEs: 61.5% vs. 66.1%; serious TEAEs: 42.3% vs. 44.8%).
In this small population of Black patients with mHSPC from the ARASENS trial, darolutamide was associated with an improvement in survival and time to CRPC and was well tolerated. Efficacy and safety findings in Black patients were consistent with the overall ARASENS population.
在 ARASENS 试验(NCT02799602)中,与安慰剂联合 ADT 和多西他赛相比,达罗他胺联合 ADT 和多西他赛显著降低了转移性去势敏感前列腺癌(mHSPC)患者的死亡风险 32.5%(HR,0.68;95%CI,0.57-0.80;P<0.0001)。我们报告了 ARASENS 中黑种人患者使用达罗他胺的疗效和安全性。
mHSPC 患者以 1:1 的比例随机分配至达罗他胺 600mg 或安慰剂,每日两次,联合 ADT 和多西他赛。主要终点为总生存。关键次要终点包括去势抵抗性前列腺癌(CRPC)时间和安全性。
在 ARASENS 中,54 名黑种人患者接受了达罗他胺(n=26)或安慰剂(n=28)联合 ADT 和多西他赛治疗。在黑种人患者中,达罗他胺组的总生存优于安慰剂组(中位无进展生存未达到 vs. 38.7 个月;分层 HR,0.41;95%CI,0.17-1.02),4 年生存率分别为 62%和 41%。与安慰剂组相比,达罗他胺组 CRPC 时间也更长(中位无进展生存未达到 vs.12.6 个月;HR,0.09;95%CI,0.02-0.30)。达罗他胺在黑种人患者中的安全性与总体 ARASENS 人群一致(3/4 级治疗相关不良事件,TEAEs:61.5% vs. 66.1%;严重 TEAEs:42.3% vs. 44.8%)。
在 ARASENS 试验的 mHSPC 黑种人小患者人群中,达罗他胺可改善生存和 CRPC 时间,且耐受性良好。黑种人患者的疗效和安全性结果与总体 ARASENS 人群一致。