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How long can you be on Xtandi?
Prostate Cancer | Last Active: 5 days ago | Replies (19)Comment receiving replies
@jeffmarc Yes, you're right. The clinicaltrials.gov page shows the trial as still in progress, but it appears that ARACOG has just presented its findings, and while patients on both Enzalutamide and Darolutamide showed a decline in cognitive test scores, the decline was greater on average with Enzalutamide. Also, the patients on Darolutamide eventually got better at the test with repetition (they remembered how it worked and gamed it a bit), while the patients on Enzalutamide did not.
Replies to "@jeffmarc Yes, you're right. The clinicaltrials.gov page shows the trial as still in progress, but it..."
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It might also be comforting to know that the absolute risk is low across the board.
Even in the "worst" case — ADT + Enzalutamide — over 91% of patients experienced no cognitive impairment. For ADT + Apalutamide, over 95% experienced no cognitive impairment, and for ADT + Abiraterone, it's over 96%. ADT + Darolutamide exhibited little increase over ADT alone (a bit over 97% had no cognitive impairment in either case), but also, they note that there was only one relevant study for Darolutamide at the time (2024):
https://dailynews.ascopubs.org/do/mental-health-and-cognitive-toxicities-androgen-receptor-signaling-inhibitors