A practical guide for the use of apalutamide for non-metastatic castration-resistant prostate cancer in Australia
- Author(s)
- Marx, G; Chowdhury, S; Krieger, L; Hovey, E; Shapiro, J; Tran, B; Tan, TH; Ng, S; Woo, HH;
- Details
- Publication Year 2024-08,Volume 20,Issue #4,Page 435-443
- Journal Title
- Asia-Pacific Journal of Clinical Oncology
- Publication Type
- Review
- Abstract
- Studies of patients with castrate-resistant prostate cancer at high risk of developing overt metastases but with no current evidence of evaluable disease on computed tomography or bone scan non-metastatic castrate-resistant prostrate cancer have demonstrated increased metastasis-free survival and overall survival following treatment with the next-generation oral anti-androgen apalutamide (in addition to therapies that aim to lower testosterone to castrate levels) or luteinizing hormone-releasing hormone antagonist or surgical castration. Patients receiving apalutamide can be managed by medical oncologists, radiation oncologists, or urologists, preferably as part of a multidisciplinary team. However, the importance of additional safety monitoring for significant adverse effects and drug interactions should not be underestimated. The toxicities of apalutamide are manageable with experience and should be managed proactively to minimize their impact on patients. Monitoring of patients for apalutamide-specific toxicities, including skin rash, hypothyroidism, and QT prolongation should be carried out regularly, particularly in the first few months following initiation. Monitoring should continue alongside monitoring for toxicities of androgen deprivation, including cardiovascular risk, hot flashes, weight gain, bone health, muscle wasting, and diabetic risk. This review is a practical guide to the use of apalutamide describing the management of patients including dosing and administration, toxicities, potential drug interactions, and safety monitoring requirements.
- Publisher
- Wiley
- Keywords
- Humans; Male; *Thiohydantoins/administration & dosage/therapeutic use/adverse effects; *Prostatic Neoplasms, Castration-Resistant/drug therapy; Australia; Androgen Antagonists/administration & dosage/adverse effects/therapeutic use; Practice Guidelines as Topic; androgen‐receptor antagonists; apalutamide; castration‐resistant; non‐metastatic; prostate cancer
- Department(s)
- Medical Oncology
- Publisher's Version
- https://doi.org/10.1111/ajco.14054
- Open Access at Publisher's Site
https://doi.org/10.1111/ajco.14054- Terms of Use/Rights Notice
- Refer to copyright notice on published article.
Creation Date: 2024-09-03 05:24:43
Last Modified: 2024-09-03 05:24:56