Apa-RP Study Suggests Potential for Apalutamide and ADT in Prostate Cancer

Vitaly Margulis, MD, professor of urology at UT Southwestern Medical Center, discusses the key takeaways of the Apa-RP study (NCT04523207) of apalutamide plus androgen deprivation therapy (ADT) in patients with high-risk localized prostate cancer, and what the next steps for this research entail.

The Apa-RP study shows promise for improving short-term biochemical recurrence rates in patients with high-risk localized prostate cancer as the study showed there to be a confirmed biochemical recurrence-free rate of 100% at 24 months (90% CI, 93.0-100.0).

While these early results are encouraging, Margulis explains that longer follow-up is crucial to assess the impact on overall survival and metastasis. Further, a prospective trial is warranted to definitively evaluate this combination's efficacy in this patient population.

Transcription:

0:09 | I would say that these data [are] encouraging. I mean, the study has shown that biochemical recurrence rates can be significantly improved, at least at the short-term, [as] sort of a shorter term study end point, meaning that I think it is a viable avenue of study. I do not think the clinical data is quite yet to immediately approve this combination for this indication, but certainly, I am hopeful that with longer follow-up and other end points, [we] would show that this could be a treatment that could be employed in these patients.

0:48 | I think a prospective trial in this space would be welcome. Surely there is a strong enough signal here to indicate that this could be a viable method and a viable treatment strategy for these patients. I think longer follow-up for this study for patients will also be meaningful to understand what happens in 5 years, what happens with metastases, what happens with overall survival, etc. But certainly, again, I think that the point here is that these early results are encouraging, they are meaningful, and I think it is worth studying further.