Prostate cancer (PCa) is one of the most common tumors in male. Castration-resistant PCa (CRPC) refers to the prostate malignancy with a PSA increase or imaging progression after androgen-deprivation therapy (ADT), which is divided into metastatic CRPC (mCRPC) and non-metastatic CRPC (nmCRPC) based on the presence or absence of imaging metastasis. Two second-generation antiandrogens, enzuramide and abiraterone, were approved for the treatment of nmCRPC in 2018. A recently completed three-stage large-scale clinical ARAMIS trial shows that the new drug, darolutamide, compared with the placebo, could prolong the metastasis-free survival (MFS) of nmCRPC patients. Darolutamide is now an anti-androgen drug available for patients with nmCRPC. This review focuses on the clinical trial of darolutamide and comparison of its therapeutic effect with that of another two second-generation antiandrogens.
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