Apalutamide for castration-resistant prostate cancer yields real-world results

Patients with nonmetastatic castration-resistant prostate cancer (nmCRPC) who have been initiated on apalutamide in a real-world setting appear to show prostate-specific antigen (PSA) response that is strong and consistent with that reported in clinical trials, as reported in a study.

The study used electronic medical records representing 63 urology practices from the US and included 193 nmCRPC patients with ≥2 apalutamide prescription fills and ≥12 months of prior prostate cancer management. These patients were followed from apalutamide initiation until a switch to a different antineoplastic treatment, death, or data unavailability.

Researchers assessed PSA response (≥50-percent decline from baseline PSA) and apalutamide adherence rates for the overall nmCRPC population treated and also stratified by race (Black and non-Black cohorts).

In the cohort, 33 patients were Black (17.1 percent) and 138 were non-Black (71.5 percent); the remaining had an unknown racial background. The mean PSA level at baseline was 7.0 ng/mL in the overall population, 10.5 ng/mL in the Black cohort, and 5.6 ng/mL in the non-Black cohort.

At the 12-month follow-up, PSA response was 86.0 percent in the overall population, 93.1 percent in the Black cohort, and 85.9 percent in the non-Black cohort.

Treatment adherence over a mean follow-up period of 333 days, 352 days, and 326 days, was 93.6 percent in the overall population, 90.1 percent in the Black cohort, and 94.5 percent in the non-Black cohorts, respectively.