In the realm of prostate cancer treatment, serum tumor markers play a pivotal role, especially prostate-specific antigen (PSA), which is highly sensitive and specific post-definitive local therapy. It can detect micrometastatic disease well before any radiographic or symptomatic evidence of disease, guiding curative-intent salvage therapies like salvage radiation upon biochemical recurrence (BCR).
A significant breakthrough comes from the ARASENS trial (NCT02799602), where darolutamide in combination with androgen-deprivation therapy (ADT) and docetaxel demonstrated a 32.5% reduction in the risk of death (HR, 0.68; 95% CI, 0.57-0.80; P < .0001) compared to placebo plus ADT with docetaxel in patients with metastatic hormone-sensitive prostate cancer (mHSPC). This trial underscores the potential of darolutamide as a formidable option in the treatment landscape for mHSPC, offering new hope for patients battling this aggressive form of prostate cancer.