Darolutamide is one of a number of therapies which have been approved for treatment of men with nonmetastatic castration-resistant prostate cancer (nmCRPC). It is taken with conventional ADT and has been shown to have significant benefit in terms of delaying the onset of metastatic disease. Darolutamide prolongs overall survival for patients with nonmetastatic castration-resistant prostate cancer (nmCRPC), according to a final analysis of the phase 3 ARAMIS Trial. An interim analysis conducted in 2019 confirmed longer metastasis-free survival.

Darolutamide reduced death risk by a significant 31% in patients with a PSA doubling time of 10 months or less.. This study led by Karim Fizazi, MD, PhD, of the Institute Gustave Roussy in Villejuif, France, was published in the New England Journal of Medicine.

Darolutamide also significantly improved key secondary endpoints at 3 years compared with placebo, including longer time to pain progression 35%, cytotoxic chemotherapy 42%, and first symptomatic skeletal event by 52%.

“An overall survival benefit was observed even though more than half the patients in the placebo group received subsequent treatment with darolutamide or another life-prolonging therapy,” Dr Fizazi’s team wrote: “This updated analysis of the ARAMIS trial confirms the low potential for central nervous system-related effects expected with darolutamide, which has been postulated to be due to the very low penetration of the blood-brain barrier that has been reported in preclinical and clinical trials of darolutamide,” Dr Fizazi’s team pointed out.

NEJM Free Article

Renal & Urology News

More than 200,000 men were identified in the US as having high-risk prostate cancer from 2004 to 2016. Of these 75 847 underwent radical prostatectomy (RP) and 104 635 underwent radiotherapy (RT).

Prostatectomy rates increased from 22.8% in 2004 to 40.5% in 2016, nearly equalling radiotherapy rates by 2016. Randomized data comparing modalities do not and likely will not exist in the foreseeable future to determine optimal treatment. The ProtecT trial compared prostatectomy vs radiotherapy and showed no difference in prostate-cancer specific mortality, but did not include a significant number of patients with high-risk prostate cancer.

The increasing use of robotic approaches suggests urologists and patients may regard prostatectomies safer than previous techniques. Conversely, a decrease in radiotherapy may reflect reluctance toward recommended androgen deprivation therapy with radiotherapy. Greater use of robotic surgery is correlated with higher income, private insurance, and treatment at an academic institution.

Men may prefer prostatectomy given the treatment burden of radiotherapy, which may change with shortened schedules. Prostatectomy rates have doubled since 2004 without guideline evidence suggesting its superiority.

Read more here

Wanted: Interviewees for a Survey

Our friends in the University of Aberdeen, in Scotland, UK are very much at the heart of the PIONEER Study and are looking for some men to be interviewed on the Core Outcome in Advance Prostate Cancer Research.

The requirements for the interviewee are:
(1) That they have advanced prostate cancer – meaning that they have an advanced PCa diagnosis and are on ADT or Chemotherapy
(2) That they can speak English.
(3) That they live in Europe but NOT the UK.

Anybody who is interested in assisting this study should contact Sheela Tripathee at Aberdeen University by email asap: sheela.tripathee@abdn.ac.uk.

Since the presentation by André Deschamps to the General Assembly last June considerable additional information on EUPROMS – our Quality of Life Survey – has been processed and is now available.

An opportunity to hear the additional information will be made available by way of a Zoom presentation led by our Chairman, André Deschamps on Thursday 1st October at 11 am CET.

This invitation is available to all members and their partners of all Europa Uomo affiliated organisations.

For organisational reasons please indicate your participation by email to the Secretariat (europauomo@skynet.be) by Monday 28th September at the latest. The secretariat will provide you with log in details.

Across Europe there has been a confusing pattern of use of masks in ordinary day-to-day activity. In some instances it has been a matter of vigorous debate and in Europe generally the merits of wearing a cloth face covering has been more measured than is the case in the United States where the wearing of masks has been politicised to an extent many of us on this side of the Atlantic find puzzling.

The recent article in the New England Journal of Medicine provides a dispassionate account of the possible value of facemasks. The value of cloth face coverings as recommended last April by the Centre for Disease Control in Atlanta was based on reports that high rates of Covid-19 virus may be shed from the noses and mouths of patients who were pre-symptomatic or asymptomatic and that these viral shedding rates were equivalent to those of symptomatic patients.

The wearing of masks may be a protection from becoming infected and also reducing the amount of viral load locally transmitted by sneezing and coughing. The article also refers to instances where mask wearing appears to have some impact where case-fatality rates in countries with mandatory or enforced population-wide masking have remained low, even with resurgences of cases after lockdowns were lifted.

The article is free and does not affect your normal article entitlement from the NEJM. Just click here.