Treatment patterns in patients with castration-resistant prostate cancer who received darolutamide in the ARAMIS trial in Spain: PARASEC study

PURPOSE: We aimed to describe treatment patterns of patients with nonmetastatic castration-resistant prostate cancer (nmCRPC) who progressed after receiving darolutamide in a real-world setting, and according to the standard clinical practice in Spain. METHODS: This was a multicenter, observational, retrospective study conducted at the urology and oncology departments of 17 Spanish hospitals that participated in the ARAMIS trial and its rollover study. RESULTS: 85 patients, with a median age of 76 years, were included in the study. 49 patients (57.6%) progressed to mCRPC, with metastases located mainly in bone. Only 35 of them (71.4%) received at least one subsequent therapy. The most common first-line treatments after darolutamide were abiraterone (n = 22, 63%) and docetaxel (n = 10, 29%), with a median (IQR) treatment duration of 7.6 months (4.7, 12.7) and 4.8 months (3.8, 5.8), respectively; besides, the most frequent first-line/second-line treatment sequences were abiraterone-docetaxel and docetaxel-cabazitaxel. In addition, only 20% of patients with bone metastases received osteoclast-targeted therapy. CONCLUSION: These real-world practice patterns suggest a lack of consensus in Spanish clinical practice for the management of patients with mCRPC, indicating that there is a need for more standardized strategies and unification of the criteria to make decisions in accordance with the recommendations of international clinical practice guidelines. CLINICAL TRIAL REGISTRATION: Not applicable.