Trial reportJournal of clinical oncology : official journal of the American Society of Clinical Oncology2024
PRESTO: A Phase III, Open-Label Study of Intensification of Androgen Blockade in Patients With High-Risk Biochemically Relapsed Castration-Sensitive Prostate Cancer (AFT-19).
Trial report in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03009981 (A Phase 3 Study of Androgen Annihilation in High-Risk Biochemically Relapsed Prostate Cancer), which is not on this map. Cited by 26 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Phase 3 Study of Androgen Annihilation in High-Risk Biochemically Relapsed Prostate Cancer
Who cites it
26 citing papers in PubMed, 1 synthesis or guideline pooled it, 41 citations in OpenAlex.
- Drug treatment options of high-risk biochemically recurrent prostate cancer based on efficacy and safety: a systematic review and Bayesian network analysis.European journal of medical research · 2025Pooled it
- Modified Citrus Pectin Treatment in Non-Metastatic Biochemically Relapsed Prostate Cancer: Long-Term Results of a Prospective Phase II Study.Nutrients · 2023Trial
- Androgen receptor pathway inhibitor intensification in non-metastatic hormone-sensitive prostate cancer: current evidence and clinical implications.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026Review
- Redefining the standard of care for high-risk biochemical recurrence of prostate cancer after definitive therapy: insights from the EMBARK final analysis.Translational andrology and urology · 2026Article
- Pathological Predictors of Limited Salvage Radiotherapy Efficacy After Radical Prostatectomy: Central Review of JCOG0401.Cancers · 2026Article
- Enzalutamide in biochemically recurrent prostate cancer: key findings from subsequent analyses of EMBARK and their implications in clinical practice.Future oncology (London, England) · 2026Article
- Real-world treatment patterns in patients with biochemical recurrence after local prostate cancer therapy.Future oncology (London, England) · 2026Observational
- Review
- Article
- Outcomes for Patients With SPOP Mutated Castration-Resistant Prostate Cancer (CRPC) Treated With an Androgen Receptor Pathway Inhibitor (ARPI).Clinical genitourinary cancer · 2026Article
- Natural History and Risk Stratification of Biochemically Recurrent Prostate Cancer Following Definitive Radiation Therapy.Advances in radiation oncology · 2026Article
- Personalized intensification of treatment for hormone-sensitive prostate cancer.Nature reviews. Clinical oncology · 2026Review
- Burden of Treatment-Induced Vasomotor Symptoms in Men With Prostate Cancer on Androgen-Deprivation Therapy: A Systematic Literature Review.Prostate cancer · 2026Review
- High-risk biochemical recurrence in prostate cancer: identification and early intervention strategies.Frontiers in urology · 2026Review
- National Cancer Institute's Working Group on Biochemically Recurrent Prostate Cancer: Clinical Trial Design Considerations.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2025Article
- Darolutamide plus androgen-deprivation therapy in high-risk biochemical recurrence of prostate cancer (ARASTEP).Future oncology (London, England) · 2025Article
- Treatment options in hormone-sensitive prostate cancer: targeting the androgen-sensitive pathway.Future oncology (London, England) · 2025Review
- Defining the Role of Postoperative Radio-Hormone Therapy in Prostate Cancer.Current oncology reports · 2025Review
- Optimizing therapy for high-risk biochemically recurrent non-metastatic prostate cancer Current and emerging strategies.Canadian Urological Association journal = Journal de l'Association des urologues du Canada · 2025Review
- Combined Fixed-duration Systemic Treatment and Metastasis-directed Radiotherapy for Oligometastatic Hormone-sensitive Prostate Cancer.European urology oncology · 2025Article
Corrections and comments
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Authors and funding
25 authors at 19 institutions in 1 country.
Funding
Abstract
purposePatients with biochemically recurrent prostate cancer (BRPC) after radical prostatectomy and a short PSA doubling time are at risk for distant metastases. Apalutamide, an androgen receptor antagonist, and abiraterone acetate plus prednisone (AAP) prolong survival in the metastatic setting. We evaluated whether intensification of androgen-deprivation therapy (ADT) improves outcomes in BRPC. PATIENTS AND
methodsPRESTO is a randomized phase III, open-label trial in patients with BRPC and PSA doubling time ≤9 months (ClinicalTrials.gov identifier: NCT03009981). Patients were randomly assigned 1:1:1 to receive a finite 52-week treatment course with ADT control, ADT + apalutamide, or ADT + apalutamide + AAP. The primary end point was PSA progression-free survival (PSA-PFS), defined as serum PSA >0.2 ng/mL after treatment completion.
resultsFive hundred three patients were enrolled. The median PSA was 1.8 ng/mL (IQR, 1.0-3.6). At the first planned interim analysis, both experimental arms significantly prolonged PSA-PFS compared with the control arm (median, 24.9 months for ADT + apalutamide
conclusionIntensified AR blockade for a finite duration prolongs PSA-PFS with a manageable safety profile, without adversely affecting time to testosterone recovery. The addition of apalutamide to ADT should be considered in patients with high-risk BRPC.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.