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Darolutamide

Phase 3

Biochemically Recurrent Prostate Cancer | Small molecule | Oncology |Bayer AG|Last Updated: Aug 10, 2026

Target and mechanism

Molecular targetAR
Target classAntagonist
ModalitySmall molecule

Also known as Darolutamide (BAY1841788, Nubeqa), Darolutamide (Nubeqa, BAY1841788), Standard Darolutamide, Darolutamide Oral Tablet

Success Probability

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Market & Valuation

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Trial Design

RandomizedDouble-BlindPLACEBO_CONTROLLEDDMC
Total Trials2
Total Enrollment1,013

FDA Designations

No designations recorded

Clinical trial landscape

Darolutamide · 14 trials · 13 indications

Phase 3 7Phase 2 6Phase 1 1
NCT06625970Study Evaluating the Efficacy and Safety of Darolutamide and Stereotactic Dose Escalated Radiotherapy in Patients With Localized Prostate Cancer and High-risk Features of RelapseHigh Risk Prostate Carcinoma
RECRUITING700 Analytics
NCT05794906A Study to Compare Darolutamide Given With Androgen Deprivation Therapy (ADT) and Placebo Given With ADT in Men With Hormone Sensitive Prostate Cancer and Raise of Prostate Specific Antigen (PSA) Levels After Local TherapiesBiochemically Recurrent Prostate Cancer
ACTIVE NOT_RECRUITING985 Analytics
NCT05116475Evaluation of dAroLutamide Addition to anDrogen Deprivation Therapy and radIatioN Therapy in Newly Diagnosed Prostate Cancer With Pelvic Lymph Nodes MetastasesProstate Cancer
RECRUITING152 Analytics
NCT04736199Darolutamide in Addition to ADT Versus ADT in Metastatic Hormone-sensitive Prostate CancerProstatic Neoplasms
COMPLETED669 Analytics
NCT04464226Study to Continue Treatment With Darolutamide in Patients Who Have Been Participating in Previous Darolutamide Studies Supported by BayerCancer
ACTIVE NOT_RECRUITING402 Analytics
NCT04136353Darolutamide Augments Standard Therapy for Localised Very High-Risk Cancer of the ProstateProstate Cancer
ACTIVE NOT_RECRUITING1,100 Analytics
NCT02200614Efficacy and Safety Study of Darolutamide (ODM-201) in Men With High-risk Non-metastatic Castration-resistant Prostate CancerProstate Cancer Non-Metastatic
COMPLETED1,509 Analytics
PHASE3RECRUITING
Study Evaluating the Efficacy and Safety of Darolutamide and Stereotactic Dose Escalated Radiotherapy in Patients With Localized Prostate Cancer and High-risk Features of Relapse
High Risk Prostate CarcinomaUnlock trial analytics
PHASE3ACTIVE NOT_RECRUITING
A Study to Compare Darolutamide Given With Androgen Deprivation Therapy (ADT) and Placebo Given With ADT in Men With Hormone Sensitive Prostate Cancer and Raise of Prostate Specific Antigen (PSA) Levels After Local Therapies
Biochemically Recurrent Prostate CancerUnlock trial analytics
PHASE3RECRUITING
Evaluation of dAroLutamide Addition to anDrogen Deprivation Therapy and radIatioN Therapy in Newly Diagnosed Prostate Cancer With Pelvic Lymph Nodes Metastases
Prostate CancerUnlock trial analytics
PHASE3COMPLETED
Darolutamide in Addition to ADT Versus ADT in Metastatic Hormone-sensitive Prostate Cancer
Prostatic NeoplasmsUnlock trial analytics
PHASE3ACTIVE NOT_RECRUITING
Study to Continue Treatment With Darolutamide in Patients Who Have Been Participating in Previous Darolutamide Studies Supported by Bayer
CancerUnlock trial analytics
PHASE3ACTIVE NOT_RECRUITING
Darolutamide Augments Standard Therapy for Localised Very High-Risk Cancer of the Prostate
Prostate CancerUnlock trial analytics
PHASE3COMPLETED
Efficacy and Safety Study of Darolutamide (ODM-201) in Men With High-risk Non-metastatic Castration-resistant Prostate Cancer
Prostate Cancer Non-MetastaticUnlock trial analytics

Study Endpoints

Primary Endpoints

Metastasis-free survival
from randomization to the onset of metastasis or death, up to 8.5 years

Metastasis-free survival (MFS) is defined as the time interval from randomization to the date of the appearance of metastasis (on next generation imaging) or death (from any cause), whichever occurs first.

Radiological progression-free survival (rPFS) by Prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) assessed by Blinded independent central review (BICR)
After randomization to after last treatment, approximately 24 months
Failure-free survival FFS
3 years

The failure-free survival is defined as the time from the date of randomization to clinical (new cancer-related symptoms), biochemical (PSA rising) or radiological (local relapse or new metastases) progression, death, end of 3-year follow-up period or lost to follow-up, whichever occurs first.

Radiological Progression-free Survival (rPFS) Assessed by Central Review
From randomization to the date when 222 rPFS events were observed, approximately 36 months

rPFS used conventional imaging method (99mTc-phosphonate bone scan, CT/MRI scan). rPFS was defined as the time from the date of randomization to the date of progressive disease in malignant soft tissue lesions, progressive disease in malignant bone lesions, or death due to any cause, whichever occurs first. Malignant soft tissue lesions were assessed by Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 criteria and malignant bone lesions were assessed by Prostate Cancer Clinical Trials Working Group (PCWG3) criteria.

Incidence of treatment-emergent adverse events (TEAEs)
Up to 4 years
Incidence of treatment-emergent serious adverse events (TESAEs)
Up to 4 years
Incidence of drug-related TEAEs
Up to 4 years
Incidence of drug-related TESAEs
Up to 4 years
3-year biochemical progression-free survival (bPFS)
Every 3 months (±14 days) up to 36 months after surgery
The proportion of participants achieving pathologic response rate (pRR: pathologic complete response [pCR] or minimal residual disease [MRD])
Completion of Follow-up 1, 30 days after last dose of study drug

pRR is defined as the proportion of participants with either condition of pCR or MRD at week 12 or 24 in corresponding arm. Proportion of participants with pCR is defined as the proportion of participants with no residual tumor detected in radical prostatectomy (RP) specimens following 12 or 24 weeks of neoadjuvant treatment of darolutamide and ADT per randomization. Proportion of participants with MRD is defined as the proportion of participants that have residual cancer burden (RCB) ≤0.25 cm\^3 in the RP specimens.

Recurrence Free Survival
Recurrence Free Survival will be monitored for a duration of 5 years.

Recurrence Free Survival (RFS), with recurrence event defined as (whichever occurs first): * Biochemical failure defined as per Phoenix criteria (i.e., a rise in PSA by 2 ng/mL or more above the nadir PSA, confirmed by a second PSA measurement) * Clinical, radiographic, or pathological evidence of local, regional, or distant recurrence/metastasis * Initiation of salvage hormonal therapy * Death from any cause.

Percent Change in Serum Testosterone
From baseline to week 12
Progression-free survival (PFS)
Approximately 12 months after end of enrollment

Time interval from enrollment to PSA progression, clinical progression or death, whichever occurs first. PSA progression is defined as when the PSA demonstrates an increase that is more than 50% of nadir, taking as reference the lowest recorded PSA level since starting androgen deprivation therapy (ADT). Clinical progression is defined as increasing symptomatic bone metastases, radiographic progression per Response Evaluation Criteria In Solid Tumors (RECIST) criteria (v. 1.1) for soft tissue metastases and PCWG3 criteria for bone metastases, or clinical deterioration due to cancer per investigator's opinion.

Darolutamide monotherapy group: Objective response rate(ORR) assessed by investigators
Up to 13 month

The proportion of patients with confirmed tumor response of complete response (CR) or partial response (PR) per RECIST 1.1, as assessed by investigators

Darolutamide and Goserelin combination therapy group: Objective response rate(ORR) assessed by an Independent Review Committee
Up to 13 month

The proportion of patients with confirmed tumor response of CR or PR per RECIST 1.1, as assessed by an independent review committee

Change in grey-matter cerebral blood flow of enzalutamide as compared to placebo
At 4 hours after drug

Obtained by comparing whole brain grey matter quantitative voxel-by-voxel maps of cerebral blood flow/ perfusion (mL per 100g tissue per min) of enzalutamide to placebo. Measured in grey matter voxels with arterial spin labeling magnetic resonance imaging (ASL-MRI).

Change in grey-matter cerebral blood flow of darolutamide as compared to placebo
At 4 hours after drug

Obtained by comparing whole brain grey matter quantitative voxel-by-voxel maps of cerebral blood flow/ perfusion (mL per 100g tissue per min) of darolutamide to placebo. Measured in grey matter voxels with ASL-MRI.

Change in grey-matter cerebral blood flow of enzalutamide as compared to darolutamide
At 4 hours after drug

Obtained by comparing whole brain grey matter quantitative voxel-by-voxel maps of cerebral blood flow/ perfusion (mL per 100g tissue per min) of enzalutamide to darolutamide. Measured in grey matter voxels with ASL-MRI.

Secondary Endpoints

Clinical Progression-Free Survival
From randomization to disease progression, up to 8.5 years
Biochemical Progression-Free Survival
From randomization to PSA relapse or death, up to 8.5 years
Time to local relapse
From randomization to local disease progression, up to 8.5 years
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Study Design & Arms

AllocationRANDOMIZED
MaskingNONE
ModelFACTORIAL
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
Arm A (Standard arm)OTHERADT + conventional fractionated or moderately hypo-fractionated prostate radiotherapy including pelvic nodal radiotherapy
Arm B (Experimental arm):EXPERIMENTALADT + conventional fractionated or moderately hypo-fractionated prostate radiotherapy including pelvic nodal radiotherapy + darolutamide
Arm C (Experimental arm):EXPERIMENTALADT + conventional fractionated or moderately hypo-fractionated pelvic nodal radiotherapy + Prostate SBRT
Arm D (Experimental arm):EXPERIMENTALADT + conventional fractionated or moderately hypo-fractionated pelvic nodal radiotherapy + Prostate SBRT + darolutamide
Darolutamide+ADTEXPERIMENTALParticipants will receive darolutamide plus ADT twice daily with food for a pre-specified duration of 24 months.
Placebo+ADTPLACEBO_COMPARATORParticipants will receive Placebo plus ADT twice daily with food for a pre-specified duration of 24 months.
Arm AEXPERIMENTALArm A: ADT + Intensity-Modulated Image-Guided Radiation Therapy + Darolutamide ADT will be associated with LHRH agonists or antagonists for 24 months4. Darolutamide regimen will be of 2 tablets of 300 mg orally twice daily for 24 months.
Arm BPLACEBO_COMPARATORArm B: ADT + Intensity-Modulated Image-Guided Radiation Therapy + Placebo of Darolutamide ADT will be associated with LHRH agonists or antagonists for 24 months4. Darolutamide regimen will be of 2 tablets of 300 mg orally twice daily for 24 months.
Darolutamide (BAY1841788)EXPERIMENTALParticipants enrolled in the current study will use the dose they were assigned to in the feeder study they come from.
DarolutamideEXPERIMENTALDarolutamide 600mg (2 x 300mg tablets) twice daily by mouth for 96 weeks, adherence monitored by participant report. All participants are treated with an LHRHA for 96 weeks from randomisation and external beam radiation therapy started within 8-24 weeks after randomisation.
PlaceboPLACEBO_COMPARATORPlacebo (2 tablets) twice daily by mouth for 96 weeks, adherence monitored by participant report. All participants are treated with an LHRHA for 96 weeks from randomisation and external beam radiation therapy started within 8-24 weeks after randomisation.
Darolutamide + docetaxel + ADTEXPERIMENTALAdopting the triple neoadjuvant treatment regimen of Darolutamide + docetaxel + ADT
Docetaxel + ADTACTIVE_COMPARATORAdopting the dual neoadjuvant treatment regimen of docetaxel + ADT
Darolutamide + ADT (12 weeks)EXPERIMENTALParticipants will receive darolutamide and androgen deprivation therapy (ADT) as neoadjuvant treatment for 12 weeks, followed by radical prostatectomy (RP).
Darolutamide + ADT (24 weeks)EXPERIMENTALParticipants will receive darolutamide and androgen deprivation therapy (ADT) as neoadjuvant treatment for 24 weeks, followed by radical prostatectomy (RP).
Group 1: Radiation Therapy OnlyACTIVE_COMPARATORParticipants randomized to Group 1 will receive radiation therapy only.
Group 2: Radiation Therapy + darolutamide + degarelixEXPERIMENTALParticipants randomized to Group 2 will receive radiation therapy only + darolutamide + degarelix.
Lead-in phase: Darolutamide treatmentEXPERIMENTALDarolutamide treatment arm is single cohort in lead-in phase.
Randomized phase: Darolutamide treatmentEXPERIMENTALThe conduct of the randomized phase is dependent on the results of the lead-in phase.
Randomized phase: Enzalutamide treatmentACTIVE_COMPARATORThe conduct of the randomized phase is dependent on the results of the lead-in phase.
Darolutamide monotherapyEXPERIMENTALTargeted patients: 24
Darolutamide plus GoserelinEXPERIMENTALTargeted patients: 32
Men_EPDEXPERIMENTALHealthy male participants receive drugs in order Enzalutamide, Placebo and Darolutamide.
Men_DEPEXPERIMENTALHealthy male participants receive drugs in order Darolutamide, Enzalutamide and Placebo.
Men_PDEEXPERIMENTALHealthy male participants receive drugs in order Placebo, Darolutamide and Enzalutamide.
Men_DPEEXPERIMENTALHealthy male participants receive drugs in order Darolutamide, Placebo and Enzalutamide.
Men_EDPEXPERIMENTALHealthy male participants receive drugs in order Enzalutamide, Darolutamide and Placebo.
Men_PEDEXPERIMENTALHealthy male participants receive drugs in order Placebo, Enzalutamide and Darolutamide.

Interventions

NameTypeDescription
DarolutamideDRUGPharmaceutical form: 300 mg tablets Administration route: oral (PO) Posology: 600 mg twice daily (BID)
Stereotactic Body RadioTherapy (SBRT)RADIATIONFollowing randomization, patients will receive dose escalated intensity modulated radiotherapy (IMRT) using normo-fractionation or moderate hypo-fractionation including whole pelvic nodal radiotherapy (WPRT). At study entry, each investigational site will be asked to choose one regimen (normo-fractionation or moderate hypo-fractionation) which will be applied for all patients included by the investigational site in the study. SBRT, experimental treatment, will be used as a boost in Arms C \& D. The placement of 3 to 4 fiducial markers for stereotactic boost is mandatory. SBRT will be applied only on Prostate: 2 times 10 Gy delivered to the prostate with a gap of one week between each SBRT fraction.
ADT (Standard of Care)DRUGAndrogen Deprivation Therapy (ADT) The ADT treatment will be chosen at the investigator's discretion, and will be administered according to local standard procedures for up to 2 years. Patients who may have received ADT prior joining the study should have started the ADT treatment within a maximum of 6 weeks before randomization. Otherwise ADT will be started on Day 1 (or 14 days at the latest after the randomization).
radiotherapyRADIATIONFollowing randomization, patients will receive dose escalated intensity modulated radiotherapy (IMRT) using normo-fractionation or moderate hypo-fractionation including whole pelvic nodal radiotherapy (WPRT). Arm A and Arm B: If Normo-fractionated radiotherapy: Pelvic nodes 46 Gy, seminal vesicles 46-54 Gy and prostate 78 Gy (39 fractions over 8 weeks). If Hypo-fractionated radiotherapy: Pelvic nodes and seminal vesicles 44 Gy in 20 fractions; prostate 60 Gy delivered concomitantly in 20 fractions over 4 weeks. Arm C and Arm D: If Normo-fractionated radiotherapy: Pelvic nodes 46 Gy, seminal vesicles 46 Gy in 23 fractions over 4.5 weeks. If Hypo-fractionated radiotherapy: Pelvic nodes and seminal vesicles 44 Gy in 20 fractions over 4 weeks.
Darolutamide (BAY1841788, Nubeqa)DRUGCoated tablet, 300 mg / tablet, oral.
Placebo matching darolutamideOTHERCoated tablet, oral
ADTOTHERLuteinizing hormone-releasing hormone \[LHRH\] agonist/antagonists
Darolutamide 300 mgDRUGDarolutamide regimen will be of 2 tablets of 300 mg orally twice daily for 24 months.
Placebo of DarolutamideDRUGPlacebo of Darolutamide regimen will be of 2 tablets of 300 mg orally twice daily for 24 months.
Darolutamide (Nubeqa, BAY1841788)DRUGCoated tablet, oral administration
PlaceboDRUGCoated tablet matching Darolutamide in appearance, oral administration
Androgen deprivation therapy (ADT)OTHERLuteinizing hormone-releasing hormone (LHRH) agonist/antagonists or orchiectomy
Placebo oral tabletDRUG2 oral tablets twice daily for 96 weeks
Luteinizing Hormone-Releasing Hormone AnalogDRUGAll participants are to receive standard background therapy with an LHRHA, as per standard of care. The choice of LHRHA is at the discretion of the treating clinician.
External Beam RadiotherapyRADIATIONAll participants are to receive standard background therapy with curative-intent RT to the prostate or prostate bed as well as the pelvic lymph nodes using EBRT.
docetaxelDRUGDocetaxel: intravenous injection, 75 mg/m², once every 3 weeks, for a total of 4 doses/cycles. (Oral prednisone acetate should be started 14 days before docetaxel chemotherapy at 5 mg twice daily and discontinued 3 weeks after the last chemotherapy cycle.)
DegarelixDRUGDegarelix is administered by subcutaneous injection. The first dose of degarelix is 240 mg followed by monthly doses of 80 mg for a total treatment duration of 6 months.
Radiation TherapyRADIATIONThe total radiotherapy dose for all subjects will be: 36.25 Gy in 5Fx. The study will not include elective nodal irradiation. Every fraction will have 3D image guidance (i.e. cone-beam CT).
Darolutamide(BAY1841788, Nubeqa)DRUGtablet, oral
EnzalutamideDRUGtablet, oral
GoserelinDRUGGoserelin at a dose of 3.6 mg will be administered subcutaneously every 4 weeks.
Darolutamide (BAY1841788)DRUG300 mg tablet darolutamide, once orally
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Eligibility Criteria

Age Range18 Years to 80 Years
SexMALE
Healthy VolunteersNo
Study Sites6

Inclusion Criteria: 1. Signed a written informed consent form prior to any trial specific procedures Note: In case of physical incapacitation, a trusted representative of their choice, which is not the investigator or sponsor, can sign on the behalf of the patients 2. Men, 18 years ≤ Age ≤ 80 y...

Countries:FranceMartiniqueUnited StatesAustraliaAustriaBelgiumBrazilCanadaChinaCzechiaDenmarkFinlandGermanyHungaryItalyJapanNetherlandsNew ZealandPolandPortugalSpainSwedenTaiwanUnited KingdomChileIndiaLatviaLithuaniaPeruRussiaSouth AfricaUkraineArgentinaBelarusBulgariaColombiaEstoniaIsraelMexicoRomaniaSerbiaSlovakiaSouth KoreaTurkey (Türkiye)Ireland
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Recent Changes (Last 90 Days)

MEDIUMAug 11, 2026NCT07450599primaryCompletionDate: changed
MEDIUMAug 11, 2026NCT07450599primaryCompletionDate: changed
MEDIUMAug 11, 2026NCT07450599primaryCompletionDate: changed
LOWJul 7, 2026NCT04464226lastUpdatePostDate: changed
LOWJul 7, 2026NCT05794906lastUpdatePostDate: changed
LOWJul 7, 2026NCT04464226lastUpdatePostDate: changed
LOWJul 7, 2026NCT05794906lastUpdatePostDate: changed

Frequently asked questions about Darolutamide

What is Darolutamide used for?

Darolutamide is an investigational small molecule being studied for the treatment of prostate cancer, including high-risk non-metastatic castration-resistant prostate cancer, metastatic hormone-sensitive prostate cancer, and high-risk localized prostate cancer. It is also being evaluated in salivary gland cancer and cerebrovascular circulation conditions. The drug is currently in Phase 3 clinical development.

What does Darolutamide target?

Darolutamide is an androgen receptor inhibitor. It works by blocking the effects of androgens, such as testosterone, on the androgen receptor, which can slow the growth of prostate cancer cells. This mechanism is being studied across multiple prostate cancer indications.

Who makes Darolutamide?

Darolutamide is being developed by Bayer AG, a German pharmaceutical company. Bayer's stock is traded over-the-counter under the ticker symbol BAYRY. The company is conducting multiple clinical trials to evaluate the drug's efficacy and safety in various prostate cancer settings.

What phase is Darolutamide in?

Darolutamide is in Phase 3 clinical development. It is an investigational drug and has not been approved by regulatory authorities. The drug is being studied in several Phase 3 trials for prostate cancer, including non-metastatic castration-resistant prostate cancer and metastatic hormone-sensitive prostate cancer.

What clinical trials is Darolutamide in?

Darolutamide is being evaluated in four clinical trials. NCT02200614 is a completed Phase 3 study in high-risk non-metastatic castration-resistant prostate cancer with 1,509 participants. NCT04464226 is an active Phase 3 extension study with 402 participants. NCT04736199 is a completed Phase 3 trial in metastatic hormone-sensitive prostate cancer with 669 participants. NCT07450599 is a recruiting Phase 2 study in high-risk localized prostate cancer with 250 participants.

Is Darolutamide the same as Nubeqa?

Yes, Darolutamide is also known as Nubeqa and BAY1841788. These names refer to the same drug substance. The drug is being developed by Bayer AG under these various names, and it is also referred to as standard Darolutamide or Darolutamide oral tablet in clinical contexts.