Clinical Report: Cognitive Effects of Darolutamide vs Enzalutamide
Overview
The ARACOG trial demonstrated that darolutamide is associated with less cognitive decline compared to enzalutamide in patients with advanced prostate cancer.
Background
Cognitive effects of cancer treatments are an important consideration for patient quality of life. The ARACOG trial provides data on the cognitive impacts of two androgen-receptor pathway inhibitors, darolutamide and enzalutamide, in advanced prostate cancer.
Data Highlights
| Parameter | Darolutamide | Enzalutamide |
|---|---|---|
| Cognitive Decline | Less | More |
| Study Duration | 24 weeks | 24 weeks |
| Participants | 111 | 111 |
Key Findings
- Darolutamide was associated with significantly less cognitive decline than enzalutamide.
- The study involved 111 men with advanced prostate cancer randomized to receive either darolutamide or enzalutamide.
- Cognitive testing was conducted using the CANTAB battery at baseline and serial follow-up.
- Only patients on enzalutamide elected to crossover during the study.
- Both agents have demonstrated overall survival benefits in previous trials.
Clinical Implications
The findings from the ARACOG trial provide data on cognitive effects of darolutamide and enzalutamide in patients with advanced prostate cancer.
Conclusion
The ARACOG trial highlights the cognitive differences between darolutamide and enzalutamide.
Related Resources & Content
- Alicia K. Morgans, MD, MPH, ASCO, 2026 -- Cognitive effects of darolutamide vs enzalutamide: Results of ARACOG (AFT-47)
- The ASCO Post — Monica M. Bertagnolli, MD, Elected ASCO President for 2018–2019 Term
- dana-farber — ASCO26: Sara Tolaney, MD, MPH, ASCENT-03
- The ASCO Post — ASCO Releases Its First-Ever Report on the State of Cancer Care in America
- the asco post — ASCO and Medicaid: Advocacy In Action
- Cognitive effects of darolutamide vs enzalutamide: Results of ARACOG (AFT-47), a randomized clinical trial from the Alliance for Clinical Trials in Oncology. | Journal of Clinical Oncology
- https://d56bochluxqnz.cloudfront.net/documents/full-guideline/EAU-EANM-ESTRO-ESUR-ISUP-SIOG-Guidelines-on-Prostate-Cancer-2026_2026-03-14-104356_ixav.pdf
- Advanced and metastatic prostate cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up†
- ASCO’s First Living Guideline in GU Cancers Reflects Recent Practice-Changing Trials on Systemic Treatment of mCRPC - The ASCO Post
- Comparison of Cerebral Blood Flow in Regions Relevant to Cognition After Enzalutamide, Darolutamide, and Placebo in Healthy Volunteers: A Randomized Crossover Trial - PMC
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