Prof Daniel Spratt speaks to ecancer about a double-blinded placebo-controlled biomarker stratified randomised trial of apalutamide (APA) and radiotherapy for recurrent prostate cancer.

This trial evaluated whether molecular subtypes defined by the PAM50 gene signature can predict benefit from adding apalutamide (APA) to salvage radiotherapy (SRT) after prostatectomy.

In this trial, total of 295 patients with rising PSA levels after surgery but no visible metastases were randomised to receive SRT with either APA or placebo for six months. Patients were stratified by PAM50 subtype (luminal B vs non-luminal B).

Dr Spratt highlights the results saying that it showed patients with luminal B tumours experienced significant improvement in biochemical progression-free survival (bPFS) and metastasis-free survival (MFS) with APA compared to placebo. In contrast, non-luminal B patients showed no benefit.

Dr Spratt adds that toxicities were generally manageable, with slightly higher rates of gastrointestinal side effects and rash in the APA group.