Real-World Results of Apalutamide in Prostate Cancer

Neeraj Agarwal, MD, a professor in the Division of Oncology, Department of Medicine, at the University of Utah School of Medicine and senior director for Clinical Research Innovation at Huntsman Cancer Institute, discusses the results of a real-world study of apalutamide (Erleada) in patients with prostate cancer across 63 United States urology practices.

The study, led by Benjamin Lowentritt, MD, and published in The Journal of Urology, found a high prostate-specific antigen (PSA) response rate in patients with nonmetastatic castration-resistant prostate cancer (nmCRPC). A positive PSA response would be indicated by 50% or more decline from the baseline PSA level, suggesting that the treatment was effective. A PSA response correlates with overall survival outcomes in patients with metastatic castration-sensitive prostate cancer, according to the TITAN (NCT02489318) and SPARTAN (NCT01946204) trials of apalutamide plus androgen deprivation therapy.

The authors also found an extremely high rate of adherence to the apalutamide treatment from patients nmCRPC after a mean of 11 months, suggesting that apalutamide can be tolerated well by most patients without adverse events leading to them stopping treatment on their own.

0:08 | So in this study, Dr Lowentritt presented the data from a real-world patient population of non-metastatic castrate-resistant prostate cancer, who were treated with apalutamide. PSA response in this study was defined as a PSA 50% response, so more than 50% PSA response. And what Dr Lowentritt showed was really reflective of what we presented from the TITAN and the SPARTAN studies. PSA responses were present in the vast majority of patients, around 86% of patients in this real-world setting, and remarkably, the adherence rates are very high. If you look at the adherence [rate] with apalutamide over this period, 93.6% of patients were adherent to the treatment with apalutamide. So in a real-world patient population, it seems like apalutamide is associated with high PSA responses and seems to be well tolerated as evidenced by the high adherence rate.