This summary describes the results from an additional (or post hoc) analysis of the TITAN study. The TITAN study looked at whether the prostate cancer treatment apalutamide could be used to treat individuals with metastatic castration-sensitive prostate cancer (or mCSPC). A total of 1052 participants with mCSPC were included in the TITAN study. Treatment with apalutamide was compared with treatment with placebo. All participants received androgen deprivation therapy (or ADT), which is a type of hormone therapy that has been part of the main treatment for mCSPC for many years. The results showed that apalutamide plus ADT increased the length of time that participants remained alive compared with placebo plus ADT. Apalutamide plus ADT also controlled the growth of the cancer for a longer length of time compared with placebo plus ADT. Additionally, participants who received apalutamide plus ADT experienced a greater reduction in the blood levels of prostate-specific antigen (or PSA), called a deep PSA decline, compared with those who received placebo plus ADT. An additional (or post hoc) analysis was carried out to understand whether a decrease in blood PSA levels, in response to treatment, was associated with improved outcomes, including longer survival time.
In participants who received apalutamide plus ADT, a deep PSA decline in response to treatment was associated with longer survival time and improved outcomes.
These results demonstrate that individuals with mCSPC can benefit from treatment with apalutamide plus ADT. The association seen between deep PSA decline and the longer survival time and improved outcomes highlights how PSA measurements can be used to help monitor cancer disease evolution in response to treatment. Monitoring PSA levels will assist doctors and other healthcare professionals to understand how effectively a treatment is working for a patient and to tailor their treatment approach to improve PSA decline.
Future oncology (London, England). 2023 Dec 21 [Epub ahead of print]
Simon Chowdhury, Anders Bjartell, Neeraj Agarwal, Byung H Chung, Robert W Given, Andrea J Pereira de Santana Gomes, Axel S Merseburger, Mustafa Özgüroğlu, Álvaro Juárez Soto, Hirotsugu Uemura, Ding-Wei Ye, Sabine D Brookman-May, Anil Londhe, Amitabha Bhaumik, Suneel D Mundle, Julie S Larsen, Sharon A McCarthy, Kim N Chi
Department of Urological Cancer, Guy's, King's & St Thomas' Hospitals, London, UK., Department of Urology, Skåne University Hospital, Lund University, Malmö, Sweden., Department of Genitourinary Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA., Department of Urology, Yonsei University College of Medicine & Gangnam Severance Hospital, Seoul, South Korea., Department of Urology, Urology of Virginia, Eastern Virginia Medical School, Norfolk, VA, USA., Department of Clinical Oncology, Liga Norte Riograndense Contra O Cancer, Natal, Brazil., Department of Urology, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany., Department of Oncology, Cerrahpaşa School of Medicine, Istanbul University-Cerrahpaşa, Istanbul, Turkey., Department of Urology, Hospital Universitario de Jerez de la Frontera, Cadiz, Spain., Department of Medicine, Kindai University Faculty of Medicine, Osaka, Japan., Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China., Janssen Research & Development, Spring House, PA, USA., Janssen Research & Development, Titusville, NJ, USA., Janssen Research & Development, Raritan, NJ, USA., Janssen Research & Development, Los Angeles, CA, USA., Department of Medicine, BC Cancer & Vancouver Prostate Centre, Vancouver, BC, Canada.