SPARTAN: apalutamide for non-metastatic castration-resistant prostate cancer
In men whose PSA was rising rapidly on hormone therapy but who had no visible metastases, apalutamide delayed the appearance of metastases by two years and later showed a survival benefit.
Overview
Phase 3 placebo-controlled trial of 1,207 men with non-metastatic castration-resistant prostate cancer and PSA doubling time of ten months or less randomised 2:1 to apalutamide or placebo with continued androgen deprivation.
Median metastasis-free survival was 40.5 versus 16.2 months (hazard ratio 0.28), and the final analysis showed median overall survival of 73.9 versus 59.9 months (hazard ratio 0.78); rash, fracture and hypothyroidism were more common with apalutamide.
- Median metastasis-free survival 40.5 vs 16.2 months; hazard ratio 0.28.
- Median overall survival 73.9 vs 59.9 months; hazard ratio 0.78.
Apalutamide, enzalutamide or darolutamide are standard for high-risk non-metastatic castration-resistant prostate cancer, a setting largely defined by conventional imaging.
- Most of these men would show metastases on PSMA PET.
- Rash in about a quarter of patients.
Similar pages
not linked directly; found by shared links- TrialA Study of Apalutamide (ARN-509) in Men With Non-Metastatic Castration-Resistant Prostate Cancer
Shares Non-metastatic castration-resistant prostate cancer, Apalutamide.
- Key paperPROSPER: enzalutamide in men with non-metastatic castration-resistant prostate cancer
Shares Non-metastatic castration-resistant prostate cancer, New England Journal of Medicine.
- Key paperARAMIS: darolutamide in non-metastatic castration-resistant prostate cancer
Shares Non-metastatic castration-resistant prostate cancer, New England Journal of Medicine.
- TermDisease volume (CHAARTED high-volume versus low-volume) and LATITUDE risk
Shares Non-metastatic castration-resistant prostate cancer, Apalutamide.
- TermPSA kinetics: PSA doubling time and PSA density
Shares Non-metastatic castration-resistant prostate cancer, Apalutamide.
- TermmCRPC and mHSPC (castration-resistant vs hormone-sensitive prostate cancer)
Shares Non-metastatic castration-resistant prostate cancer, Apalutamide.