Bayer's supplemental new drug application (sNDA) for Nubeqa (darolutamide), an oral androgen receptor inhibitor (ARi), has been accepted by the U.S. Food and Drug Administration (FDA) for the treatment of patients with metastatic hormone-sensitive prostate cancer (mHSPC). This application seeks to expand the current indications for Nubeqa, potentially offering a new treatment option for a broader range of patients with mHSPC.
The sNDA is supported by data from the Phase III ARANOTE trial (NCT04736199), a randomized, double-blind, placebo-controlled study involving 669 patients. The trial evaluated Nubeqa in combination with androgen deprivation therapy (ADT) against placebo plus ADT. The primary endpoint was radiological progression-free survival (rPFS), which was met, demonstrating a significant benefit for the Nubeqa arm.
Clinical Trial Details and Endpoints
The ARANOTE trial randomized patients to receive either 600mg of Nubeqa twice daily or a matching placebo, in addition to ADT. Key secondary endpoints included overall survival time, time to castration-resistant disease, time to initiation of subsequent anticancer therapy, time to prostate-specific antigen (PSA) progression, PSA undetectable rates, time to pain progression, and safety assessments. The results of the ARANOTE trial were published in the Journal of Clinical Oncology.
Current Indications and Market Impact
Nubeqa is currently indicated for adult patients with mHSPC in combination with docetaxel and for non-metastatic castration-resistant prostate cancer. According to Bayer's 2023 financial report, Nubeqa generated €869 million ($949 million) in sales last year. GlobalData estimates peak sales of $3.6 billion by 2029, reflecting the drug's growing importance in prostate cancer therapy.
Expert Commentary
Christine Roth, executive vice president at Bayer, stated, "Bayer is dedicated to addressing unmet needs in prostate cancer treatment for various stages of the disease, and today’s acceptance of our sNDA application for Nubeqa plus ADT for the treatment of patients with mHSPC brings us closer to adding an additional treatment option for Nubeqa to benefit those living with mHSPC. If approved, this would expand the indication for Nubeqa in patients with mHSPC to include Nubeqa both with and without chemotherapy, providing physicians and their patients with an additional Nubeqa treatment option in this setting. We are working closely with the FDA to bring this additional Nubeqa treatment option to patients as soon as possible."
