Dr Morgans on QOL With Darolutamide in mHSPC

Alicia Morgans, MD, MPH, discusses quality-of-life analyses from the ARANOTE and ARASENS trials and what they show about adding darolutamide (Nubeqa) to androgen deprivation therapy (ADT) in metastatic hormone-sensitive prostate cancer (mHSPC). Her focus is how treatment intensification affects the way patients feel, along with how well their disease is controlled.

Morgans, a genitourinary medical oncologist at Dana-Farber Cancer Institute, explains that ARANOTE provided a valuable way to understand the quality-of-life impact of adding darolutamide to ADT in this patient population. In the analysis, quality of life was actually preserved among patients who received the intensified regimen of darolutamide plus ADT compared with those treated with ADT alone.

She describes this finding as somewhat counterintuitive. There is often an assumption that adding another medication will inherently make a patient feel worse, but that was not what investigators observed in ARANOTE. Morgans says this is something she values knowing as a clinician.

Another notable result from ARANOTE was the connection between PSA response and quality of life. The lower PSA levels fell, the better quality of life appeared to be. As patients achieved deeper responses in terms of cancer control, they also had a longer time to pain progression and a better quality of life.

Morgans then turns to ARASENS. In that analysis, adding darolutamide had minimal effect on quality of life, and investigators found that quality of life could be maintained in this patient population. According to Morgans, this supports the goal of giving patients both excellent cancer control and excellent quality of life.

She explains that these 2 objectives go hand in hand in her own practice. She wants patients to live longer, and she also wants them to feel as well as they can. Morgans notes that the ARANOTE and ARASENS analyses were important in helping her understand how darolutamide performs on both fronts, which also informs how she communicates these data to patients.

In this discussion, Morgans walks through the quality-of-life evidence from both trials, the relationship between PSA response, pain progression, and patient well-being, and why these findings matter in her conversations with patients about treatment intensification with darolutamide.