Dr Morgans talks to ecancer at ASCO 2026 about results she presented from the phase 2 ARACOG (AFT-47) randomized trial.

Darolutamide was associated with significantly less cognitive decline than enzalutamide in patients with advanced prostate cancer, including metastatic hormone-sensitive and castration-resistant disease.

Dr Morgans notes that among 111 enrolled patients, cognitive function assessed by the CANTAB platform showed a smaller median decline in the most affected cognitive domain at 24 weeks with darolutamide (-15.8%) compared with enzalutamide (-36.1%; p=0.009).

Darolutamide-treated patients demonstrated stable or improved performance across several domains, suggesting a potential learning effect, whereas enzalutamide was associated with stable to worsening scores.

All treatment crossovers occurred from enzalutamide to darolutamide, primarily due to cognitive deterioration, supporting a more favorable central nervous system tolerability profile for darolutamide.