@brianjarvis AFAIK, there hasn't been a lot of head-to-head overall-survival comparison of the ARSIs (pulling numbers from different studies with different methodologies into the same table or website can be highly misleading), and there haven't been many real-world assessments comparing side-effects, either.

That's what's so interesting about the big retrospective study I shared earlier: it was limited to nmCRPC (probably because -lutamides other than Apalutamide hadn't been approved long enough for mCSPC to provide good samples), and while it found that Apalutamide produced the fewest de-novo central-nervous-system side-effects and Enzalutamide produced the most (with Darolutamide in the middle), they were all so close that it likely doesn't matter to patients, just to the marketing departments at Johnson & Johnson, Pfizer, and Bayer.

tl;dr All the -lutamides are good. Bayer's marketing may be feeding us 🐂💩 about Nubeqa's central-nervous system advantages over the others, while Johnson & Johnson's may be feeding us the same about Erleada's overall survival advantages. I suspect the only reason Pfizer's isn't joining in with Xtandi is that their U.S. Enzalutamide composition patent expires in 2027 anyway. 🤷