Apalutamide and Overall Survival in Prostate Cancer
PUBLISHED: 28 SEPTEMBER 2020
The recent SPARTAN study reported apalutamide to improve metastasis-free survival by 2 years in nonmetastatic castration-resistant prostate cancer (nmCRPC), but overall survival data were immature. This study follow-up provided a longer-term to evaluate overall survival. A total of 1207 patients with nmCRPC (diagnosed by conventional imaging) were randomized 2:1 to apalutamide or placebo plus ongoing androgen-deprivation therapy. Of note, 19% of patients still receiving placebo crossed over to apalutamide during unblinding. At median 52-months' follow-up, the authors found that overall survival was markedly longer with apalutamide versus placebo (73.9 vs 59.9 months; HR, 0.78). Apalutamide also lengthened the time to chemotherapy compared with placebo. The authors concluded that apalutamide in nmCRPC confers a 22% reduction in the hazard of death (despite 19% crossover). These findings support the value of apalutamide as a treatment option for nmCRPC.