Androgen Receptor Pathway Inhibitor Therapy for Advanced Prostate Cancer: Secondary Analysis of a Randomized Clinical...

Area of Science:

• Oncology
• Clinical Trials
• Prostate Cancer Research

Background:

• Advanced castration-sensitive prostate cancer (CSPC) requires effective treatment strategies.
• Evaluating treatment impacts on patient health-related quality of life (HRQOL) is crucial.
• The LACOG0415 trial compared three treatment regimens for advanced CSPC.

Purpose of the Study:

• To assess the association between different treatment strategies and HRQOL in advanced CSPC patients.
• To compare HRQOL outcomes for androgen deprivation therapy (ADT) plus abiraterone acetate and prednisone (AAP) versus apalutamide (APA) alone or APA plus AAP.

Main Methods:

• An open-label, randomized phase 2 trial (LACOG0415) involving 128 advanced CSPC patients.
• Patients were randomized to ADT plus AAP, APA alone, or APA plus AAP.
• HRQOL was measured using the Functional Assessment of Cancer Therapy-Prostate (FACT-P) questionnaire up to 25 weeks.

Main Results:

• No statistically significant differences in mean FACT-P scores were observed between the three treatment arms at 25 weeks.
• HRQOL was generally maintained across all treatment groups.
• The apalutamide (APA) alone arm showed a statistically favorable time to deterioration in emotional well-being compared to ADT plus AAP.

Conclusions:

• In advanced CSPC, APA alone or APA plus AAP did not demonstrate statistically significant HRQOL improvements over ADT plus AAP.
• Further research with longer follow-up and diverse questionnaires is needed to fully understand HRQOL differences.
• The study provides insights into HRQOL outcomes for novel treatment combinations in advanced CSPC.