Key clinical point: Androgen receptor inhibitors (ARIs) improve survival in patients with nonmetastatic castration-resistant prostate cancer (CRPC) regardless of age. Older patients (age, 80 years and above ) experience higher rates of high-grade and serious adverse events.
Major finding: ARIs vs placebo improved overall survival in older (adjusted hazard ratio [aHR], 0.79; 95% confidence interval [CI], 0.64-0.98) and younger patients (aHR, 0.69; 95% CI, 0.60-0.80). ARIs also improved metastasis-free survival in older (aHR, 0.37; 95% CI, 0.28-0.47) and younger patients (aHR, 0.31; 95% CI, 0.27-0.35). Patients who received ARIs vs placebo experienced higher rates of adverse events.
Study details: A pooled analysis of 3 randomized trials including patients with nonmetastatic CRPC randomly assigned to receive ARI (apalutamide, enzalutamide, or darolutamide; n=2,694) or placebo (n=1,423).
Disclosures: The study did not receive any funding. The authors declared no competing interests.
Source: Fallah J et al. Lancet Oncol. 2021 Jul 23. doi: 10.1016/S1470-2045(21)00334-X .