Expert discusses real-world survival with apalutamide vs abiraterone in mCSPC

In this video, Mehmet Asim Bilen, MD, discusses the background and key findings from the study, “Analysis of real-world survival for patients with metastatic castration-sensitive prostate cancer (mCSPC) treated with apalutamide (APA) or abiraterone acetate (ABI) in an oncology database: ROMA study,” which was presented at the 2024 ASCO Genitourinary Cancers Symposium in San Francisco, California. Bilen is the director of genitourinary medical oncology at the Winship Cancer Institute of Emory University in Atlanta, Georgia.

Video Transcript:

Just like our previous data [where] we compared apalutamide and enzalutamide in metastatic castration sensitive prostate cancer patients, in this work, we compare apalutamide vs abiraterone. Those are really the 3 drugs we can pick, and currently, all those are effective and available. But at the end of the day, we really don't know how to choose which 1, and because of this reason, we conducted this analysis. We looked at the FlatIron database and dissected patients who received apalutamide or abiraterone in our analysis cohort. We had roughly 250 patients receive apalutamide, and a little over 600 patients receive abiraterone. Roughly 57%, white vs 17% Black. When we look at median on treatment, it was 11.4 [months] for apalutamide vs 10.8 months on abiraterone. When we look at the landmark survival, which is the 24 months, 85.7% of the APA cohort survived vs 75.9% on the abiraterone, based on unadjusted analyses and hazard ratio is 0.60. It's statistically significant. Overall, our conclusion is we observed more benefit in apalutamide vs abiraterone. But again, we need to do multivariate analyses and try to control as much as factors that might affect the outcome. Hopefully that will be done in our future work.

This transcription has been edited for clarity.