In men with metastatic castration-sensitive prostate cancer, adding apalutamide to conventional androgen-deprivation therapy can produce a 52% increase in the rate of radiographic progression-free survival, researchers report.

In their first interim analysis of the international TITAN study, funded by the manufacturer of the drug, a 24-month progression-free survival (PFS) rate of 68% was achieved in the apalutamide arms compared with 49% for placebo therapy in addition to androgen-deprivation therapy, at a median follow-up of 23 months.

“The effect of apalutamide on radiography progression-free survival was consistently favourable across the subgroups analysed, including previous docetaxel use and both high- and low-volume disease,” the researchers said.

Overall survival was 82% and 74% respectively, a difference that was statistically significant, reflecting a 33% lower risk of death, with very similar rates of grade 3 or 4 side effects.