Low-Dose Enzalutamide in Metastatic Prostate Cancer—Longevity Over Conventional Survival Analysis

Low-Dose Apalutamide in Nonmetastatic Castration-Resistant Prostate Cancer: A Case Report

“…There was no pain, rash, or other common adverse effects in this case [ 9 ]. Response to low-dose apalutamide in the patient is in line with our earlier observation with enzalutamide, concordant with the similarity of the molecules (Figure 1 ) [ 7 ].…”

“…There was no pain, rash, or other common adverse effects in this case [9]. Response to low-dose apalutamide in the patient is in line with our earlier observation with enzalutamide, concordant with the similarity of the molecules (Figure 1) [7]. Compared with results from the Selective Prostate AR Targeting with ARN-509 (SPARTAN) study, despite poorer ECOG, higher PSA, and a lower starting dose of apalutamide, treatment duration was longer even after accounting for the COVID-19 discontinuation (Table 1).…”

“…Although current evidence supports using a 240 mg dose of apalutamide for nmCRPC, we reasoned by analogy that a reduced dosage of 60 mg/d, or 25% of the recommended dose, could be considered in the elderly patient, as had been done with enzalutamide [ 6 ]. The structural similarity between apalutamide and enzalutamide, along with comparable adverse effect profiles, suggested that low-dose apalutamide could be as efficient as conventional-dose apalutamide, the same way that low-dose enzalutamide was found as efficient as standard-dose enzalutamide in the elderly [ 7 ]. By sharing a retrospective case, for which informed consent has been obtained, we aimed to provide valuable insights gained from treating an elderly man who had nmCRPC.…”

Comparison of standard-dose and reduced-dose treatment of metastatic prostate cancer with enzalutamide, apalutamide or darolutamide: a rapid review

“…The study found that men receiving low-dose enzalutamide had better longevity (restricted mean attained age: 89.1 years in low-dose enzalutamide vs 83.3 years in standard dose patients, p=0.025), as well as fewer adverse events. 24 In a similar analysis of 59 patients with metastatic prostate cancer aged ≥75 years, 25 43 men received low-dose enzalutamide (≤80 mg/day) and 16 the standard dose (160 mg/day). PSA response (reduction of ≥50% from baseline) was observed in 18 (45%) and 10 (67%) patients receiving low and standard-dose enzalutamide at 12 weeks (p=0.15), respectively.…”

Androgen receptor pathway inhibitors, prostate cancer, and older adults: a global Young International Society of Geriatric Oncology drug review

“… 82 A follow-up retrospective by the same authors revealed that starting with a ⩽50% dose of enzalutamide (⩽80 mg/day) versus standard dose (160 mg/day) may also improve longevity (measured by restrict-mean survival time) while lowering AEs and not compromising efficacy; this effect was seen regardless of age. 83 A dose reduction strategy does have pharmacologic grounding. Data from pharmacodynamic /pharmacokinetic studies of enzalutamide show that antitumor effect is seen at all doses, 84 and no single plasma trough level quartile was associated with a significantly better response.…”