The Link Between Apalutamide and QOL in Non-Metastatic CRPC

Excerpt:

“Adding apalutamide to androgen deprivation therapy (ADT) does not appear to harm health-related quality of life (HRQOL) in men with nonmetastatic castration-resistant prostate cancer (CRPC), according to new research published in Lancet Oncology.

“Previous research has showed that men in this patient population who received apalutamide had longer metastasis-free survival and a longer time to symptomatic progression compared with those who received placebo. This new study found that adding apalutamide still preserves HRQOL. Specifically, the group mean patient-reported outcome scores over time demonstrated HRQOL was maintained from baseline (initiation of apalutamide), and it was similar over time among men receiving apalutamide versus placebo.”

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Apalutamide Maintains Health-Related QoL in Nonmetastatic CRPC

Excerpt:

“Treatment with apalutamide (Erleada) was not associated with a significant impact on health-related quality of life (HRQoL) in patients with high-risk nonmetastatic castration-resistant prostate cancer, according to patient-reported outcome (PRO) data from the phase III SPARTAN trial.

“In the study overall, patients treated with the addition of apalutamide to standard hormone therapy also had an improvement in metastasis-free survival (MFS) and longer time to symptomatic progression compared with those who were treated with placebo.”

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Combo Tx No Help After PSA Progression in mCRPC

Excerpt:

“Adding abiraterone acetate (Zytiga) to enzalutamide (Xtandi) did not improve progression-free survival (PFS) after prostate-specific antigen (PSA) progression in men on enzalutamide monotherapy for chemotherapy-naive metastatic castration-resistant prostate cancer (mCRPC), researchers found.

“In the randomized, double-blind PLATO trial, the median PFS in patients treated with enzalutamide plus abiraterone and prednisone was 5.7 months. By comparison, the PFS was 5.6 months in the control group treated with abiraterone and prednisone plus placebo (hazard ratio [HR] 0.83; P=0.22).”

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FDA Approves Enzalutamide for Nonmetastatic CRPC

Excerpt:

“The FDA has approved enzalutamide (Xtandi) for the treatment of patients with nonmetastatic castration-resistant prostate cancer (CRPC), according to Pfizer and Astellas, the codevelopers of the antiandrogen agent.

“The approval is based on the phase III PROSPER trial, in which the combination of enzalutamide (Xtandi) and androgen deprivation therapy (ADT) reduced the risk of metastases or death by 71% compared with ADT alone for patients with nonmetastatic CRPC. In the double-blind study, the median metastasis-free survival (MFS) was 36.6 months with enzalutamide plus ADT versus 14.7 months with ADT alone (HR, 0.29; 95% CI, 0.24-0.35; P <.0001).”

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Apalutamide Reduces Risk of PSA Progression by 94% in Nonmetastatic CRPC

Excerpt:

“Apalutamide (Erleada) lowered the risk of PSA progression by 94% in patients with nonmetastatic castration-resistant prostate cancer (CRPC), according to a posthoc analysis from the phase III SPARTAN trial presented at the 2018 American Urological Association (AUA) Annual Meeting.

“The median time to PSA progression was not reached in the apalutamide arm compared with 3.71 months in the placebo group (HR, 0.064; 95% CI, 0.052-0.080; <.0001). A separate retrospective cohort study presented at AUA underscored the significance of these apalutamide data by confirming prior observations of the link between faster PSA doubling time (PSADT) and poorer metastasis-free survival (MFS) and overall survival (OS).”

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Xtandi Granted Priority Review for Prostate Cancer Treatment

Excerpt:

“The Food and Drug Administration granted Xtandi (enzalutamide) a priority review to a supplemental new drug application for the treatment of patients with nonmetastatic castration-resistant prostate cancer, according to the companies developing the drug, Pfizer and Astellas.

“The sNDA is based on data from the phase 3 PROSPER trial in which the combination of Xtandi and androgen deprivation therapy (ADT) reduced the risk of metastases or death by 71 percent compared with ADT alone for patients with nonmetastatic CRPC. In the double-blind study, the median metastasis-free survival (MFS) was 36.6 months with Xtandi plus ADT versus 14.7 months with ADT alone.”

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Apalutamide Granted FDA’s Priority Review for Nonmetastatic CRPC

Excerpt:

“Based on data from the phase III SPARTAN trial (ARN-509-003), apalutamide (ARN-509) has been granted a priority review by the FDA for the treatment of patients with nonmetastatic castration-resistant prostate cancer (CRPC), according to Janssen Biotech, the manufacturer of the next-generation oral androgen receptor inhibitor.

“The trial evaluated the safety and efficacy of apalutamide versus placebo in patients with a rapidly rising prostate specific antigen (PSA) level despite receiving continuous androgen deprivation therapy (ADT). The primary endpoint of the study is metastasis-free survival.”

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Bipolar Androgen Therapy Induces PSA Reductions in Metastatic CRPC

Excerpt:

“The use of bipolar androgen therapy (BAT), involving rapid cycling between high and low serum concentrations, was safe and resulted in responses and resensitization to enzalutamide in men with metastatic castration-resistant prostate cancer (CRPC) who progressed after initial enzalutamide therapy, according to a new study.

“ ‘Clinically, metastatic CRPC that has progressed after enzalutamide treatment is minimally responsive to further therapy that inhibits androgen receptor signaling,’ wrote study authors led by Benjamin A. Teply, MD, of Johns Hopkins School of Medicine in Baltimore. ‘Theoretically, rapidly varying the androgen concentrations between the extremes of supraphysiological and near-castrate, a strategy termed BAT, provides insufficient time for CRPC cells to adaptively regulate androgen receptor concentrations,’ and thus may promote cancer cell death and prevent resistance.”

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Apalutamide Granted FDA’s Priority Review for Nonmetastatic CRPC

Excerpt:

“Based on data from the phase III SPARTAN trial (ARN-509-003), apalutamide (ARN-509) has been granted a priority review by the FDA for the treatment of patients with nonmetastatic castration-resistant prostate cancer (CRPC), according to Janssen Biotech, the manufacturer of the next-generation oral androgen receptor inhibitor.

“The trial evaluated the safety and efficacy of apalutamide versus placebo in patients with a rapidly rising prostate specific antigen (PSA) level despite receiving continuous androgen deprivation therapy (ADT). The primary endpoint of the study is metastasis-free survival.”

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