Dr. Alicia Morgans of Dana-Farber Cancer Institute reported at #ASCO26 that ARACOG found darolutamide was associated with less decline in cognitive testing than enzalutamide, which may help guide treatment choice.
The information that I am presenting at ASCO 2026 is on the ARICOG or AFT 47 trial, which is the first randomized comparison of patients with advanced prostate cancer receiving either dalutamide or enzalutamide as an AR pathway inhibitor treatment for their uh prostate cancer. The primary endpoint for this study is really an important and unique one, because it is cognitive function and it's the maximally changed cognitive domain for patients who are being treated in either of these treatment arms. The important part is that we're trying to understand, as the most important factor in this study, whether either of these treatments actually causes more or less change in cognitive function. Cognitive function, of course, is an important factor as patients are being treated for their advanced cancer and may influence clinicians treating decisions. When we did this comparison and assessed it at the primary endpoint, which was 24 weeks after starting treatment, we found that enzalutamide-treated patients had a greater decline in cognitive function by the cognitive tests than patients who were treated with dralutamide. And this change is something that occurred initially at by even 12 weeks and then persisted by 24 weeks. Patients within the study could also choose to cross over from one treatment to the other treatment if they felt that this would benefit them, uh, despite, of course, these agents being considered equal in terms of how well they treat the cancer and more patients crossed from enzalutamide to dalutamide during this treatment and follow-up period. We're excited to report this data at ASCO because I do think that in settings where both of these treatments are available, particularly for people who might be most vulnerable, like older adults or those with early cognitive change already, understanding these differences may impact how patients and also their treating physicians make decisions between these agents.
