100% BCR-Free at 2 Years: Promising Early Results for High-Risk Prostate Cancer


Vitaly Margulis, MD, discusses the significance of a 100% biochemical recurrence-free rate at 2 years, and what this means for patients with high-risk localized prostate cancer.

Vitaly Margulis, MD, professor of urology at UT Southwestern Medical Center, explains the significance of a 100% biochemical recurrence (BCR)-free rate at 2 years, and what this means for patients with high-risk localized prostate cancer.

In the Apa-RP study (NCT04523207), investigators evaluated adjuvant treatment with apalutamide and androgen deprivation therapy (ADT) in this patient population to see if the combination improved the BCR-free rate. The results were positive with a confirmed BCR-free rate of 100% at 24 months (90% CI, 93.0-100.0).

While this is an early surrogate end point and longer end points will be more meaningful, Margulis explains that these data are compelling.


0:09 | The standard treatment in this particular population is observation. So I would have expected at 2 years, a significant proportion of these patients would have experienced biochemical disease recurrence. Certainly, there is no doubt that this study has demonstrated that we can improve the biochemical recurrence rate for these patients.

0:31 | There are several questions that remain, although I am very optimistic. And there is really a need for effective adjuvant treatment options for these patients. It should be remembered that this study looked at biochemical disease recurrence, which is kind of an early surrogate end point. It is a good end point, it is meaningful. And also, we should remember the timing. We were looking at this for 2 years, essentially 1 year of treatment. So this is, I would say, kind of an earlier end point and it certainly should be kept in mind that this is a biochemical recurrence end point.

1:07 | I would say [this is] encouraging data. I think I would advise the listener to be cautiously optimistic and sort of follow-up and [know that] longer end points and more meaningful end points. But certainly, the data so far is compelling and meaningful.

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