Abstract | BACKGROUND: OBJECTIVE: To evaluate the association of a rapid, deep PSA decline at 3 and 6 mo achieved with the addition of apalutamide to ADT with patient-reported outcomes (PROs) in SPARTAN and TITAN. DESIGN, SETTING, AND PARTICIPANTS: A post hoc analysis of SPARTAN and TITAN PRO data was performed. INTERVENTION: OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: PROs were assessed using Functional Assessment of Cancer Therapy-Prostate (FACT-P; SPARTAN and TITAN), Brief Pain Inventory-Short Form (BPI-SF; TITAN), and Brief Fatigue Inventory (BFI; TITAN) at baseline, prespecified cycles during treatment, and after progression for ≤1 yr. The association between a deep PSA decline at landmark 3 or 6 mo of apalutamide and the time to worsening of PROs was assessed using the Kaplan-Meier methodology and Cox proportional-hazard modeling. RESULTS AND LIMITATIONS: Among 806 SPARTAN and 525 TITAN apalutamide-treated patients, the median treatment duration was 32.9 and 39.3 mo, respectively. Patients achieving a deep PSA decline at 3 mo had longer time to worsening in FACT-P total, FACT-P physical well-being, BPI-SF worst pain intensity, or BFI worst fatigue intensity. The 6-mo PSA decline results were similar. Limitations of patient characteristics in clinical studies should be considered. CONCLUSIONS: Attaining a deep and rapid PSA decline at 3 mo with apalutamide plus ADT was associated with longer preservation of overall HRQoL and physical well-being in nmCRPC and mCSPC. PATIENT SUMMARY:
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Authors | Eric J Small, Kim N Chi, Simon Chowdhury, Katherine B Bevans, Amitabha Bhaumik, Fred Saad, Byung Ha Chung, Lawrence I Karsh, Stéphane Oudard, Peter De Porre, Sabine D Brookman-May, Sharon A McCarthy, Suneel D Mundle, Hirotsugu Uemura, Matthew R Smith, Neeraj Agarwal |
Journal | European urology oncology
(Eur Urol Oncol)
(Dec 09 2023)
ISSN: 2588-9311 [Electronic] Netherlands |
PMID | 38072759
(Publication Type: Journal Article)
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Copyright | Copyright © 2023 European Association of Urology. Published by Elsevier B.V. All rights reserved. |