Treatment of non-metastatic castration resistant prostate cancer in 2020: What is the best?

Abstract

Lately the development of 3 novel second-generation androgen receptor antagonists (enzalutamide, apalutamide, and darolutamide) chanced the treatment landscape of nonmetastatic castration-resistant prostate cancer. After proofing their clinical efficacy in large phase III registration trials with good compatibilities and tolerable side effects currently all 3 substances are Food and Drug Administration-approved in nonmetastatic castration-resistant prostate cancer. The present short review article provides an overview about these new treatment options and discusses their use in daily routine focusing on patient selection as well as on the impact of novel sensitive imaging modalities like prostate-specific membrane antigen-positron-emission tomography for detection of this stage of disease.

Keywords: Adverse events; Apalutamide; Darolutamide; Enzalutamide; Nonmetastatic castration-resistant prostate cancer; PSMA-PET.