Perioperative apalutamide plus ADT improves event free survival in high risk localised prostate cancer

Prof Alberto Briganti speaks to ecancer about the PROTEUS substudy, which evaluated perioperative apalutamide plus androgen deprivation therapy (ADT) alongside radical prostatectomy and pelvic lymph node dissection in patients with high risk localised or locally advanced prostate cancer.

Compared with surgery alone, perioperative apalutamide plus ADT significantly improved event free survival, reducing the risk of recurrence or death by 62%.

Prof Briganti highlights that the combination also reduced the risk of metastasis or death by 51% and the need for subsequent treatment by 71%. Grade 3 or 4 adverse events occurred in 30.7% of patients receiving apalutamide plus ADT, compared with 21.7% undergoing surgery alone.

These findings support the potential role of perioperative systemic treatment in improving outcomes following surgery in high risk prostate cancer.