Perioperative Apalutamide in High-Risk Localized Prostate Cancer.

Perioperative ADT plus apalutamide improves pathological response and metastasis-free survival in high-risk prostate cancer patients undergoing prostatectomy, with 8.9% achieving complete response.

• Why it matters: High-risk localized or locally advanced prostate cancer often relapses within five years despite radical prostatectomy, highlighting the need for more effective perioperative treatments to improve long-term outcomes.
• What they did: A phase 3, double-blind trial involving 2109 patients compared ADT plus apalutamide versus ADT plus placebo, assessing pathological response, metastasis-free survival, and safety over a median follow-up of 61.7 months.
• The result: Patients receiving apalutamide showed significantly higher rates of complete response and metastasis-free survival, with improved event-free and treatment-free survival, though adverse events like rash were more common.