Real-world comparison of enzalutamide and apalutamide in metastatic hormone-sensitive prostate cancer: a multi-institutional propensity score-matched analysis - PubMed
7 hours ago
- #real-world-data
- #androgen-receptor-inhibitors
- #prostate-cancer
- Enzalutamide (Enz) and apalutamide (Apa) combined with androgen deprivation therapy (ADT) are standard treatments for metastatic hormone-sensitive prostate cancer (mHSPC).
- A retrospective study of 227 mHSPC patients (112 Enz, 115 Apa) found similar PSA responses (94.5% Enz vs. 92.0% Apa achieved ≥90% PSA decline) and comparable time to castration resistance (TTCR) and overall survival (OS).
- Time to treatment failure (TTF) was significantly shorter with Apa (P = 0.0016), and adverse events (AEs) leading to discontinuation were more frequent with Apa (20.9% vs. 4.5% Enz).
- Reduced-dose initiation was more common with Apa (22.1% vs. 9.8% Enz), but TTCR did not differ by starting dose.
- Second-line therapy use after treatment failure was similar (86.4% Enz vs. 90.2% Apa), with abiraterone being the most common choice.
- The study highlights comparable efficacy but higher AE-related discontinuation with Apa, warranting cautious interpretation due to limited event numbers.