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Treatment of non-metastatic castration-resistant prostate cancer: focus on apalutamide

Anita Gul1, Jorge A Garcia1, Pedro C Barata2

  • 1Department of Hematology/Medical Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH, USA.

Cancer Management and Research
|September 20, 2019
PubMed

Insights

Novel androgen receptor (AR)-targeted therapies show promise for non-metastatic castration-resistant prostate cancer (nmCRPC). These treatments, including enzalutamide and apalutamide, help delay disease progression in advanced prostate cancer patients.

Area of Science:

  • Oncology
  • Urology
  • Pharmacology

Background:

  • Androgen deprivation therapy (ADT) is a cornerstone for advanced prostate cancer.
  • Resistance to ADT is a significant clinical challenge.
  • Novel androgen receptor (AR)-targeted therapies offer new treatment avenues.

Purpose of the Study:

  • To review the role of AR and ADT in prostate cancer.
  • To discuss mechanisms of ADT resistance and the nmCRPC landscape.
  • To examine the clinical development and application of apalutamide in nmCRPC.

Main Methods:

  • Literature review of key studies and clinical trials.
  • Discussion of pharmacologic characteristics of apalutamide.
  • Analysis of apalutamide's efficacy in nmCRPC and ongoing research.

Main Results:

  • Three major studies confirm efficacy of novel AR-targeted therapies.
  • Enzalutamide and apalutamide are FDA-approved for nmCRPC.
  • These therapies prolong metastasis-free survival and time to symptomatic progression.

Conclusions:

  • AR-targeted therapies represent a significant advancement for nmCRPC.
  • Apalutamide demonstrates clinical utility in this patient population.
  • Further research is ongoing to explore apalutamide's role across prostate cancer stages.
Keywords:
ARN-509androgen receptorapalutamidenon-metastatic castration-resistant prostate cancerPhase III trials

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