Evidence map›Paper›PMID 41851476›Full record

ArticleProstate cancer and prostatic diseases2026

Real-world analysis of androgen receptor inhibitors in US patients with nonmetastatic castration-resistant prostate cancer: DEAR-EXT study.

Neal D Shore, Daniel J George, Nasreen Khan, Niculae Constantinovici, Guifang Chen, Mercedeh Ghadessi, Vlasta Hlebec, Alicia K Morgans

Registry-linked trialAbstract read
PubMed Publisher
In one paragraph

Article in Prostate cancer and prostatic diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06013475 (Use of Darolutamide, Enzalutamide and Apalutamide for Non-metastatic Castration-Resistant Prostate Cancer), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06013475 completednot on this map

Use of Darolutamide, Enzalutamide and Apalutamide for Non-metastatic Castration-Resistant Prostate Cancer (nmCRPC) - EXTension of the DEAR Real-world Study (NCT05362149)

TypeobservationalSponsorBayerRan2023 to 2024Enrolled1,375ConditionsNon-metastatic Castration-resistant Prostate CancerArmsApalutamide, Darolutamide (BAY 1841788), Enzalutamide
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Neal D ShoreSTART Carolinas/Carolina Urologic Research Center, Myrtle Beach, SC, USA. nshore@auclinics.com.ORCID http://orcid.org/0000-0001-5767-0548
Daniel J GeorgeDuke Cancer Institute, Duke University School of Medicine, Durham, NC, USA.ORCID http://orcid.org/0000-0002-0836-8542
Nasreen KhanBayer HealthCare Pharmaceuticals, Inc., Whippany, NJ, USA.
Niculae ConstantinoviciBayer Consumer Care AG, Basel, Switzerland.
Guifang ChenBayer HealthCare Pharmaceuticals, Inc., Whippany, NJ, USA.
Mercedeh GhadessiBayer HealthCare Pharmaceuticals, Inc., Whippany, NJ, USA.
Vlasta HlebecBayer Consumer Care AG, Basel, Switzerland.
Alicia K MorgansDana-Farber Cancer Institute, Boston, MA, USA.ORCID http://orcid.org/0000-0002-6563-4587

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe real-world retrospective DEAR study in patients with nonmetastatic castration-resistant prostate cancer (nmCRPC) demonstrated darolutamide was associated with lower risks of discontinuation and progression to metastatic castration-resistant disease vs enzalutamide and apalutamide. This analysis expands on DEAR, including additional patients and follow-up, comparing prostate-specific antigen (PSA) response, metastasis-free survival (MFS), and overall survival (OS).

methodsDEAR-EXT was a chart review of electronic medical records from patients in US urology practices who initiated androgen receptor inhibitors (ARIs) for nmCRPC from August 2019-March 2023. Outcomes included time to initial drug discontinuation, time to metastatic castration-resistant prostate cancer (mCRPC), PSA response, MFS, OS, and safety. Adjusted Cox proportional hazards models were used for the primary analysis and inverse probability of treatment weighting and other sensitivity analyses were performed to evaluate the impact of potential selection bias and confounding factors.

resultsPatients (N = 1375) received darolutamide (n = 565, 41%), enzalutamide (n = 609, 44%), or apalutamide (n = 201, 15%). Baseline characteristics were mainly similar across groups. Adjusted risk of discontinuation was significantly lower with darolutamide vs enzalutamide (hazard ratio [HR] 0.73, 95% confidence interval [CI] 0.61-0.88) and vs apalutamide (HR 0.69, 95% CI 0.54-0.89). Adjusted risk of progression to mCRPC was lower with darolutamide vs enzalutamide (HR 0.63, 95% CI 0.50-0.80) and vs apalutamide (HR 0.72, 95% CI 0.53-0.98). MFS was significantly longer for darolutamide vs enzalutamide (HR 0.65, 95% CI 0.53-0.79) and vs apalutamide (HR 0.72, 95% CI 0.55-0.93). The estimated MFS rates at 24/36 months were 72.3%/60.2% with darolutamide, 59.2%/48.3% with enzalutamide, and 63.9%/47.6% with apalutamide. Darolutamide appeared to be associated with higher PSA response, improved survival, and fewer adverse events vs other ARIs in a real-world setting. Results were consistent in a sensitivity analysis.

conclusionDarolutamide demonstrated lower discontinuation rates, longer time to progression, and longer MFS vs other ARIs, highlighting its potential to enhance real-world patient outcomes. CLINICAL

trial registrationClinicalTrials.gov identifier: NCT06013475.

Identifiers

PMID41851476

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.