Dr. Zurita-Saavedra on Leveraging Antiandrogen Agents in Metastatic HSPC

Amado J. Zurita-Saavedra, MD, assistant professor, associate professor, Department of Genitourinary Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, discusses the utilization of the antiandrogen agents apalutamide (Erleada) and enzalutamide (Xtandi) in patients with metastatic hormone-sensitive prostate cancer (mHSPC). 

The phase 3 TITAN trial (NCT02489318) examined apalutamide vs androgen deprivation therapy (ADT) in patients with mHSPC. One of the primary end points of the trial was overall survival, and data confirmed that apalutamide extended survival vs ADT, according to Zurita-Saavedra. 

The implications of TITAN and the phase 3 ARCHES trial (NCT02677896), which evaluated enzalutamide vs ADT in the same patient population, are similar, Zurita-Saavedra adds. In both trials, the patients derived benefit from the antiandrogen agents, as patient-reported outcomes indicated that quality of life (QoL) did not decline with the agents, Zurita-Saavedra explains.

Adverse effects were found to be tolerable by most patients, Zurita-Saavedra says. Additionally, apalutamide and enzalutamide have proven to be useful in extending life and improving patient QoL beyond the point of symptomatic progression of prostate cancer and all the complications related to disease progression in select patients, Zurita-Saavedra concludes.