(UroToday.com) The SPARTAN study of the androgen receptor (AR) antagonist apalutamide in combination with androgen deprivation therapy (ADT) demonstrated significantly improved overall survival relative to ADT alone in patients with high-risk nonmetastatic castration-resistant prostate cancer.
A previously presented analysis applying the Decipher Genomic Classifier (GC) showed overall worse prognosis for patients on SPARTAN with a high GC score, though apalutamide was able to provide patient benefit regardless of GC score. In this analysis, Dr. Saad presented the results of an exploratory biomarker analysis examining the association between GC score (high - score > 0.6 versus low – score <= 0.6), basal or luminal phenotype, and clinical variables such as PSA kinetics.
Regarding PSA kinetics, all patients receiving apalutamide, neither basal/luminal subtype or GC score were associated with different PSA kinetics. Similarly, all molecular subtypes derived metastasis-free and overall survival benefit from apalutamide treatment, though the greatest benefit was observed in the luminal and GC-high phenotypes.
Presented by: Fred Saad, MD, FRCS, Professor and Chief of Urology, Director of Genitourinary Oncology, University of Montreal Hospital Centre, Montreal, Ontario
Written by: Alok Tewari, MD, Ph.D., Medical Oncology Fellow at the Dana-Farber Cancer Institute, at the 2020 American Society of Clinical Oncology Virtual Annual Meeting (#ASCO20), May 29th-May 31st, 2020