Perioperative Apalutamide in High-Risk Localized or Locally Advanced Prostate Cancer Reduces Risk of Metastasis and Death - Summary - MDSpire
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Perioperative Apalutamide in High-Risk Localized or Locally Advanced Prostate Cancer Reduces Risk of Metastasis and Death
High-risk localized and locally advanced prostate cancer patients treated with apalutamide — a next generation neoadjuvant androgen-receptor pathway inhibitor (ARPI) — plus hormone therapy before and after prostate cancer surgery resulted in more major pathologic responses and reduced the risk of metastasis or death, meeting both primary endpoints, in an international phase 3 clinical trial led by principal investigator Mary-Ellen Taplin, MD, medical oncologist at Dana-Farber Cancer Institute, and Adam Kibel, MD, chair of the Department of Urology at Mass General Brigham.
To evaluate the efficacy of apalutamide combined with hormone therapy in reducing metastasis and death in high-risk localized or locally advanced prostate cancer patients.
Key Findings:
Apalutamide plus ADT resulted in a 20% reduced risk of metastasis or death.
Five-year metastasis-free survival probability was 78.2% for the apalutamide group compared to 73.5% for hormone therapy alone.
Patients treated with apalutamide were nine times more likely to have little to no cancer present at surgery.
8.9% of patients on the apalutamide regimen achieved a pathologic complete response or minimal residual disease, compared to 1.0% in the control group.
The study delayed subsequent therapy by 33 months.
Interpretation:
The findings suggest that perioperative apalutamide combined with hormone therapy may significantly improve outcomes for patients with high-risk localized or locally advanced prostate cancer.
Limitations:
Conclusion:
The results of the PROTEUS trial may reshape the standard of care for high-risk prostate cancer patients.
