Real-World Experience of ENZA vs DARO

Author(s):

A panelist discusses how the outcomes of this study broadly align with real-world treatment patterns and clinical experiences, where enzalutamide and darolutamide both demonstrate efficacy in metastatic hormone-sensitive prostate cancer (mHSPC), although practical considerations such as darolutamide’s more favorable central nervous system (CNS) toxicity profile and enzalutamide’s longer clinical experience often influence prescribing decisions based on individual patient characteristics and comorbidities

EP: 1.Matching-Adjusted Indirect Comparisons in mHSPC

EP: 2.Key Limitations of MAIC Analyses

EP: 3.Study Design: Comparing the ARCHES and ARANOTE trials

EP: 4.Key Takeaways From an Indirect Comparison of ENZA and DARO in mHSPC

EP: 5.Key Differences Between Enzalutamide and Darolutamide

EP: 6.Deciding on a Treatment Approach for mHSPC

EP: 7.Findings in the Docetaxel-Naive Patient Population

EP: 8.Treatment Decisions in Patients With Low- vs High-Volume Disease

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EP: 9.Real-World Experience of ENZA vs DARO

EP: 10.Explaining Study Results to Your Patients

Summary for Physicians: Study Outcomes vs Real-World Experience With Enzalutamide and Darolutamide

The relationship between clinical trial results and real-world experience with enzalutamide and darolutamide shows important patterns:

Efficacy consistency: Real-world effectiveness generally aligns with trial results, though response rates may be more variable in practice.
Side effect profiles: The differentiated CNS toxicity profile of darolutamide (less fatigue, falls, cognitive effects) appears to be maintained in clinical practice.
Patient selection: Real-world prescribing patterns increasingly favor darolutamide for older patients and those with significant comorbidities.
Adherence patterns: Treatment discontinuation rates may be higher in real-world settings than in clinical trials for both agents.
Sequence flexibility: Clinicians report successful use of these agents in various treatment sequences not fully explored in trials.

The alignment between trial data and clinical experience supports the use of either agent in mHSPC, with selection increasingly guided by toxicity profiles and patient-specific factors rather than efficacy differences alone.