Apalutamide improves overall survival

Apalutamide added to ongoing androgen deprivation therapy (ADT) significantly improves overall survival (OS) in patients with nonmetastatic castration-resistant prostate cancer (nmCRPC).

Earlier results from the SPARTAN study had showed that apalutamide could improve metastasis-free survival by two years but OS data was immature.

This follow-up paper published in European Urology (doi.org/10.1016/j.eururo.2020.08.011) reports on 1207 patients with nmCRPC randomized 2:1 to apalutamide or placebo plus ongoing ADT. At median 52-months’ follow-up, the authors found that OS was significantly longer with apalutamide versus placebo (73.9 versus 59.9 months; hazard ratio, 0.78 [95% CI, 0.64­–0.96]; p=0.016). Apalutamide also lengthened the time to chemotherapy compared with placebo (HR, 0.63 [95% CI, 0.49–0.81]; p=0.0002).

According to the authors apalutamide in nmCRPC confers a 22% reduction in the hazard of death despite a significant cross over from the placebo to the active treatment. These findings support the value of apalutamide as a treatment option for nmCRPC, they say.

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