Researchers say the use of apalutamide (Erleada) in patients with high-risk, nonmetastatic castration-resistant prostate cancer improves metastasis-free survival (MFS) in patients who have previously undergone radical prostatectomy or external radiotherapy—regardless of the type of treatment they received.
A recent clinical trial showed the use of apalutamide in patients with high-risk nonmetastatic castration-resistant prostate cancer demonstrates a more than 2-year increase in MFS and a 55% reduction in time to symptomatic progression (N Engl J Med 2018; 378:1408-18).
In the current study, presented at the AUA annual meeting in Chicago, researchers sought to determine whether treatment with apalutamide, a next-generation androgen receptor inhibitor, provided the same benefit and safety profile in patients who had previously undergone radical prostatectomy and/or external radiotherapy as it does in those who have not.
The authors, from multiple institutions, separated patients randomly into two groups: those who received apalutamide (240 mg once per day) and androgen deprivation therapy (ADT) and those who received a placebo and ADT. The apalutamide-plus-ADT group was about twice as large as the ADT-and-placebo group. Forty-one percent of patients in each group (334/806 apalutamide; 166/401 placebo) had undergone radical prostatectomy or external radiotherapy prior to the study. Patient outcomes were evaluated based on any radical prostatectomy or external radiotherapy received prior to the study.