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The hormone treatment called apalutamide is usually used in the context of advanced stage prostate cancer. A study by American researchers reports that the treatment could also be administered to men at an early stage of the disease, in order to reduce the rate of positive biopsies. The opinion of Pr Michael Peyromaure, head of the urology department at Cochin hospital.
“Apalutamide is a hormonal treatment administered to patients affected by prostate cancer at a metastatic or even lymph node stage. first of all indicates Professor Peyromaure. Indeed, this molecule is part of a class of new hormonal agents approved for the treatment of advanced prostate cancer. A team of American researchers has studied the possibility of administering it to patients at the early stage of the disease.
A phase II study involving 23 men
In this study published in The Journal of Urology, lead author Dr. Michael T. Schweizer of the University of Washington and his team performed a preliminary Phase II study including 23 men with an average age of 67. . The aim is therefore to determine whether the addition of apalutamide to the active surveillance of men with early-stage prostate cancer could affect the cancer detection rate during follow-up biopsies.
All patients received 90 days of oral treatment with apalutamide, at a dose of 240 milligrams daily, and opted for active surveillance for initial treatment of prostate cancer, considered “low to intermediate risk“.
Just over half of patients have no signs of cancer
Results: 59% of patients, or 13 out of 22, who completed apalutamide treatment as planned had no evidence of residual cancer at immediate post-treatment biopsy. At long-term follow-up, cancer-free biopsy rates were 33% at one year, or 7 out of 21 patients, and 21% at two years, or 4 out of 19 patients.
“In our study, 59% of men receiving 90 days of apalutamide treatment had no evidence of residual prostate cancer at follow-up biopsy immediately after treatmentcomments the lead author. Furthermore, in 65% of patients included in the study, PSA levels decreased by 90% or more with the addition of apalutamide. Five patients eventually underwent radiotherapy or surgery surgery for prostate cancer after a median of about two years.
The opinion of Pr Michael Peyromaure, head of the urology department at Cochin Hospital in Paris
“Apalutamide is a hormonal treatment that slightly improves progression-free survival in patients who benefit from it, i.e. men with advanced stage prostate cancer. It is not a treatment revolutionary but we can recognize a little effectiveness. On the other hand, there is no interest in my opinion, to want to treat men with cancer at an early stage, who in addition have chosen active surveillance. We have the means of monitoring and the treatments necessary to treat them if necessary, when the disease is at a localized stage. Administering hormone treatment is not without consequences for these patients, because they present significant side effects.“concludes the specialist.