Prostate cancer is cancer of the prostate gland (a small organ in a man’s pelvis) and is the second most common cancer in the UK. There are three stages: localised, locally‐advanced and advanced (or metastatic) prostate cancer. The symptoms may vary depending on the stage of cancer but can include pain, tiredness, problems emptying the bladder and the bowels. About half of men diagnosed with locally‐advanced prostate cancer will see their cancer spread to other body organs (i.e. becoming metastatic). Prostate cancer growth and spread depends on the hormone, testosterone. Cancer that do not respond to hormonal treatment to reduce the level of testosterone are known as castrationresistant prostate cancer.
Darolutamide is a hormonal drug under development for castration resistant prostate cancer that has not spread (non‐metastatic). It acts by blocking testosterone receptors from getting activated on the cancer cells and consequently reducing the size of the cancer. Darolutamide is taken orally twice a day. If licenced, darolutamide will provide an additional treatment option for men with non‐metastatic castration‐resistant prostate cancer that are at high risk of their cancer spreading to other parts of the body.
Selinexor is the first treatment option that targets XPO1, a protein that is responsible for exporting tumour suppressor proteins from the cell nucleus. It belongs to a new family of therapies called selective inhibition of nuclear export (SINE) compounds that blocks XPO1 leading to controlled death of myeloma cells. Currently there is no standard of care for the fifth line treatment of MM. Selinexor and low-dose dexamethasone are being developed as an oral treatment. If licensed, this combination could be an effective treatment option for a patient group with clear unmet need.