Castration-resistant prostate cancer (CRPC) without any metastases on conventional imaging is classified as non-metastatic CRPC (nmCRPC). Patients with nmCRPC progress to metastatic disease and are at risk of developing cancer-related symptoms (pain, pathological bone fractures etc.).
Effective management of nmCRPC should aim to delay metastatic progression. Second generation androgen receptor inhibitors (apalutamide, enzalutamide and darolutamide) have been demonstrated the longer median of metastases free survival and overall survival than placebo in patients with nmCRPC.
Darolutamide is a structurally unique androgen receptor inhibitor with low penetration of blood-brain barrier and lower incidence of adverse events than others androgen receptor inhibitors.