Apalutamide in the treatment of patients with high-risk prostate cancer
Keywords:
prostate, prostate neoplasms, castration-resistant prostate neoplasms, neoplasm metastasis, prostate-specific antigen, nonsteroidal antiandrogens.Abstract
Introduction: Apalutamide is a selective inhibitor of the androgen receptor. It has been approved for the treatment of hormone-sensitive metastatic and castration-resistant prostate cancer in combination with androgen deprivation therapy.
Objective: To assess the tolerability and response of prostate-specific antigen in patients with high-risk prostatic adenocarcinoma ongoing apalutamide therapy.
Methods: An observational, analytical, longitudinal and prospective study of 22 patients who presented prostate cancer and were treated with apalutamide at the "Reina Sofía" Hospital in Murcia between 2019 and 2022 was conducted. Data such as the Gleason scale were collected if they received any previous treatment, presence of metastases and analytical results. Side effects, treatment discontinuation and disease progression were also reviewed.
Results: 15 patients presented metastatic hormone-sensitive prostate cancer (Group 1) and 7 were resistant to non-metastatic castration (Group 2). Of group 1, 80 % presented debut metastases and 73.33 % were low volume. Prostate-specific antigen decreased by 94.39% in group 1 and 81.68% in group 2. Of the total, 59.09 % suffered side effects. The most frequent were fatigue (27.27 %), followed by hypothyroidism (18.18 %) and high blood pressure (9.09 %). All were mild except for the appearance of severe leukopenia that caused treatment to be interrupted. There was progression in one patient of group 1.
Conclusions: Apalutamide in patients with high-risk prostate cancer is an effective and well-tolerated option, with a decrease in prostate-specific antigen >50%, which may increase overall and progression-free survival.
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References
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