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Treatment of non-metastatic castration-resistant prostate cancer: focus on apalutamide

Authors Gul A, Garcia JA, Barata PC

Received 19 April 2019

Accepted for publication 15 July 2019

Published 1 August 2019 Volume 2019:11 Pages 7253—7262


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Editor who approved publication: Professor Harikrishna Nakshatri

Anita Gul,1 Jorge A Garcia,1 Pedro C Barata2

1Department of Hematology/Medical Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH, USA; 2Tulane University, New Orleans, LA, USA

Abstract: Androgen deprivation therapy (ADT) is an important component of systemic therapy in advanced prostate cancer; however, resistance to ADT is inevitable. Three large studies demonstrated the efficacy of novel androgen receptor (AR)-targeted therapies in prolonging metastasis-free survival and time to symptomatic progression in patients with non-metastatic castration-resistant prostate cancer (nmCRPC). Enzalutamide and apalutamide have been approved by the FDA in the nmCRPC setting. This review discusses the role of AR and ADT in prostate cancer, mechanism of ADT resistance and the nmCRPC stage. In addition, pharmacologic characteristics and clinical development of apalutamide, role of apalutamide in nmCRPC, and ongoing clinical studies of apalutamide in different stages of prostate cancer are discussed.

Keywords: androgen receptor, non-metastatic castration-resistant prostate cancer, apalutamide, ARN-509, Phase III trials

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