Darolutamide is the newest. Has the least side effects. You’ve already been on Enzalutamide so apalutamide is almost definitely not going to help. It works the same as Enzalutamide as does Darolutamide. You need to go another direction.

If you have not been on Zytiga then it may be the best bet for the next drug, but you have to speak to your oncologist to find that out. Zytiga is hard on the heart. Can raise your blood pressure. Causes hot flashes to become more intense. Makes the brain fog worse. But it can give more years of low PSA.

Another option is BAT where you have testosterone injections to try and reset the ability of Enzalutamide to work again. Doesn’t always work.