Open Access

HOW I DO IT

How I do it: Apalutamide use in non- metastatic castrate resistant prostate cancer

Judd W. Moul

Division of Urology, Department of Surgery and Duke Cancer Institute, Durham, North Carolina, USA
Address correspondence to Dr. Judd W. Moul, Division of Urology, Duke University, 3707 DUMC, Durham, NC 27710 USA

Canadian Journal of Urology 2019, 26(3), 9782-9786.

Abstract

Urologistshavebeenusingoralnonsteroidalantiandrogens (AA) for 30 years as a component of combined androgen blockade. In February 2018, a new third generation AA, apalutamide, became available for the frst time for non-metastatic (M0) castrate resistant prostate cancer (CRPC). Apalutamide was found to delay the presence of metastases (metastases free survival-MFS) by approximately 2 years versus placebo in M0 CRPC. While overall survival beneft has yet to be established, the MFS beneft is clinically meaningful and urology practices should be equipped to manage patients using thisneworalagent.Sincethemajorityofpatientsremain under urologic care when this disease stage develops and becausethedrugisstraightforwardtoadminister,urology practices are ideal to identify and treat. The objective of thisbriefarticleistodiscussthetypicalpatientproflefor use of apalutamide and to review the pros and cons of use and common side effects and management.

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