Real‐world study: Impact of multidisciplinary management of apalutamide‐associated adverse events in prostate cancer

Abstract

AbstractObjectiveTo analyse the adverse events (AEs) associated with apalutamide and the impact of a multidisciplinary team (MDT) protocol on its management at a tertiary care hospital in a real‐world setting.MethodsThis was an observational, prospective, cohort study based on real‐world evidence at the Hospital Clínic de Barcelona. Includes patients diagnosed with metastatic hormone‐sensitive prostate cancer (mHSPC) or high‐risk nonmetastatic castration‐resistant prostate cancer (nmCRPC) and who started treatment with apalutamide between May 2019 and March 2023 in a real‐world clinical setting.ResultsOf the 121 patients treated with apalutamide, 52.1% experienced an AE, 19.8% experienced temporarily interruption or a reduction in the dose of apalutamide, and 13.2% discontinued treatment due to AEs. Without MDT protocol (49 patients), 24.5% of patients had to temporarily interrupt or reduce the dose of apalutamide due to AEs, with a median time from the start of treatment of 10.1 months, and 24.5% discontinued apalutamide due to AEs, with a median time from the start of treatment of 3.1 months. Meanwhile, whit MDT protocol (72 patients), 16.7% of patients had to temporarily interrupt or reduce the dose of apalutamide due to AEs, with a median time from the start of treatment of 1.6 months, and 5.6% discontinued apalutamide due to AEs, with a median time from the start of treatment of 4 months. The risk reduction associated with treatment discontinuation was statistically significant (p‐value = 0.003).ConclusionsThis study highlights the importance of MDT management of AEs associated with apalutamide to reduce treatment discontinuation.