ARAMIS STUDY DESIGN
The largest double-blind, placebo-controlled, international, multicenter study in nmCRPC to date1-5
- Treatment continued until radiographic disease progression as assessed by conventional imaging (CT, MRI, 99mTc bone scan) by blinded independent central review, discontinuation due to adverse reactions, or withdrawal of consent1
*All patients received concurrent ADT (treatment with GnRH analog or previous bilateral orchiectomy).
†Lymph nodes located below the aortic bifurcation as measured by the short axis.
Study endpoints
PRIMARY ENDPOINT1
- Metastasis-free survival
SECONDARY ENDPOINTS1,5
- Overall survival
- Time to pain progression‡
- Time to first cytotoxic chemotherapy
- Time to first symptomatic skeletal event
EXPLORATORY ENDPOINTS5
- Progression-free survival
- Time to first prostate cancer–related procedure
- Time to initiation of subsequent chemotherapy
- PSA progression and response
- Deterioration in ECOG PS
- Quality of life§
‡Time to pain progression was defined as at least a 2-point worsening from baseline of pain score on BPI-SF (a validated health-related quality-of-life instrument) or initiation of opioids and reported in 28% of all patients on study.
§Tools used to prespecify quality-of-life exploratory endpoints are the EQ-5D-3L, a preference-based instrument, and the FACT-P, BPI-SF, and EORTC-QLQ-PR25 prostate-specific questionnaires.
Patient Demographics
Well-balanced patient characteristics in ARAMIS2,5
The majority of patients (68%) had an ECOG PS of 0 at baseline, defined as fully active and able to carry on all pre-disease performance without restriction2,5,6
- 43% of patients were on an antithrombotic, such as apixaban, clopidogrel, rivaroxaban, or warfarin2
- More than a third of patients were on a statin (34.5%), such as atorvastatin, pravastatin, or rosuvastatin2
Bone-sparing agents included bisphosphonates, denosumab, vitamin D and analogs, calcium and calcium combinations, fluorides, and calcitonins.2
ECOG PS is graded according to the following criteria: 0: Fully active, able to carry on all pre-disease performance without restriction; 1: Restricted in physically strenuous activity but ambulatory and able to carry out work of a light or sedentary nature, eg, light housework, office work.6
ADT=androgen deprivation therapy; BPI-SF=Brief Pain Inventory-Short Form; CRPC=castration-resistant prostate cancer; CT=computed tomography; ECOG PS=Eastern Cooperative Oncology Group Performance Status; EORTC-QLQ-PR25=European Organization for Research and Treatment of Cancer quality of life questionnaire, a 25-item questionnaire; EQ-5D-3L=EuroQol Group 5-dimension 3-level; FACT-P=Functional Assessment of Cancer Therapy–Prostate; GnRH=gonadotropin-releasing hormone; MRI=magnetic resonance imaging; nmCRPC=non-metastatic castration-resistant prostate cancer; PSA=prostate-specific antigen; PSADT=prostate-specific antigen doubling time.
References: 1. NUBEQA (darolutamide) [prescribing information]. Whippany, NJ: Bayer HealthCare Pharmaceuticals, Inc.; October 2023. 2. Data on file. Bayer HealthCare Pharmaceuticals, Inc.; Whippany, NJ. 3. Xtandi (enzalutamide) [prescribing information]. Northbrook, IL: Astellas Pharma US, Inc.; January 2022. 4. Erleada (apalutamide) [prescribing information]. Horsham, PA: Janssen Products, LP; April 2022. 5. Fizazi K, Shore N, Tammela TL, et al. Darolutamide in nonmetastatic, castration-resistant prostate cancer. N Engl J Med. 2019;380(13):1235-1246. 6. ECOG-ACRIN Cancer Research Group. ECOG Performance Status Scale. https://ecog-acrin.org/resources/ecog-performance-status/. Accessed September 19, 2023.