Apalutamide vs Abiraterone for Deep PSA Response in MHSPC patients

[NPfisherman]

Salutations FPC'ers,

New retrospective study from MD Anderson for ASCO 2023 evaluating the 2 ARPI drugs for deep PSA response in hormone sensitive patients. While the number of patients were not exactly even in each group, the study indicates that apalutamide has a greater initial decrease in PSA than abiraterone.

Clearly, further studies should be done in drug to drug comparisons to determine which drug is indeed the best for initial treatment in MHSPC patients. The fact that at 6 months, patients started on apalutamide were 53% more likely to achieve a 90% reduction in PSA than those on abiraterone is impressive.

pubmed.ncbi.nlm.nih.gov/370...

I would like to see a prospective study to eliminate possible bias comparing abi vs enza vs apa to determine which is best...

As always, I welcome questions...

Don Pescado

PS: The Science is Coming !!!

[MateoBeach]

That’s a good piece of the puzzle for those who must make a decision now rather than some years down the road when such a RCT can be mature. That is how the Science comes. In pieces, partial glimpses revealed. As Alan Watts wrote: “Cloud Hidden, Whereabouts Unknown” Pablo

[pca2004]

The same authors recently reported something similar for Apalutamide versus Enzalutamide [1]:

"By 6 months, patients initiated on apalutamide had a 56% greater likelihood of attaining PSA90 than those initiated on enzalutamide ..."

"The median time to achieving PSA90 was 3.1 months with apalutamide and 5.2 months with enzalutamide."

-Patrick

[1] pubmed.ncbi.nlm.nih.gov/370...

[NPfisherman in reply to pca2004]

Patrick,

I saw this info after putting up the article and meant to put it up today....2022 ASCO...Thanks for posting this reply. I directed Rickytarr to your reply since he was evaluating apa vs enza in a previous post...

Fish