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Published on: March 6, 2018
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Low-dose Apalutamide in Non-metastatic Castration-resistant Prostate Cancer: A Case Series
Minh Dung Nguyen1, Johan Rose Dite Modestine2, Yannick Djoua2
1King's College Hospital, London, U.K. nguyenmdmd@gmail.com.
Anticancer Research
|June 27, 2025
Summary
Low-dose apalutamide showed effectiveness in treating non-metastatic castration-resistant prostate cancer (nmCRPC). This suggests a potential for optimized dosing strategies to improve patient outcomes.
Area of Science:
- Oncology
- Pharmacology
Background:
- Apalutamide is an approved androgen receptor (AR) inhibitor for prostate cancer.
- The minimal effective dose of apalutamide is not well-established.
Purpose of the Study:
- To evaluate the efficacy of low-dose apalutamide in patients with non-metastatic castration-resistant prostate cancer (nmCRPC).
Main Methods:
- Retrospective chart review of nmCRPC patients receiving ≤60 mg/day apalutamide.
- Inclusion criteria: confirmed prostate cancer, rising PSA, no distant metastasis, low testosterone.
- PSA response defined as >50% decrease at week 12; results compared to dose-escalation study data.
Main Results:
- Six elderly patients (mean age 81.1 years) with nmCRPC were analyzed.
- All patients achieved a PSA decrease at 12 weeks (p=0.031), with a median time to 50% PSA decrease of 21.6 days.
- Five of six patients survived a median follow-up of 2.44 years, with some achieving undetectable PSA or stable disease.
Conclusions:
- Low-dose apalutamide demonstrated effectiveness in this small case series of nmCRPC patients.
- A proposed apalutamide dosing flowchart may help individualize treatment and avoid higher doses.
- Further dose-response studies are warranted to confirm optimal apalutamide dosing.
