Evidence map›Paper›PMID 40327314›Full record

ArticleInternational journal of clinical pharmacy2025

Real-world clinical outcomes of apalutamide versus abiraterone with androgen deprivation therapy for metastatic hormone-sensitive prostate cancer.

Eduardo Pons-Fuster, Celia Maria Gonzalez-Ponce, Silverio Ros-Martinez, Juan José Fernández-Ávila, María Sacramento Díaz-Carrasco, Alberto Espuny-Miró

Abstract readComparative Study
In one paragraph

Article in International journal of clinical pharmacy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Eduardo Pons-FusterClinical Pharmacy and Therapeutics Research Group, Servicio de Farmacia Hospitalaria, Virgen de la Arrixaca University Clinical Hospital (HCUVA), Ctra. Madrid-Cartagena, s/n, 30120, El Palmar, Spain. eduardo.p.f@um.es.ORCID http://orcid.org/0000-0001-9595-5982
Celia Maria Gonzalez-PonceClinical Pharmacy and Therapeutics Research Group, Servicio de Farmacia Hospitalaria, Virgen de la Arrixaca University Clinical Hospital (HCUVA), Ctra. Madrid-Cartagena, s/n, 30120, El Palmar, Spain.
Silverio Ros-MartinezClinical and Translational Oncology Research Group, Clinical Oncology Unit, Virgen de la Arrixaca University Clinical Hospital (HCUVA), El Palmar, Spain.
Juan José Fernández-ÁvilaClinical Pharmacy and Therapeutics Research Group, Servicio de Farmacia Hospitalaria, Virgen de la Arrixaca University Clinical Hospital (HCUVA), Ctra. Madrid-Cartagena, s/n, 30120, El Palmar, Spain.
María Sacramento Díaz-CarrascoClinical Pharmacy and Therapeutics Research Group, Servicio de Farmacia Hospitalaria, Virgen de la Arrixaca University Clinical Hospital (HCUVA), Ctra. Madrid-Cartagena, s/n, 30120, El Palmar, Spain.
Alberto Espuny-MiróClinical Pharmacy and Therapeutics Research Group, Servicio de Farmacia Hospitalaria, Virgen de la Arrixaca University Clinical Hospital (HCUVA), Ctra. Madrid-Cartagena, s/n, 30120, El Palmar, Spain.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMetastatic hormone-sensitive prostate cancer (mHSPC) is an aggressive disease with a poor prognosis. Current treatment guidelines recommend combining androgen receptor axis-targeted therapies (ARATs) with androgen deprivation therapy (ADT) for mHSPC. While individual ARATs have shown success, few studies directly compare their effects.

aimTo compare the safety and clinical outcomes of abiraterone acetate (abiraterone) and apalutamide in chemotherapy-naïve mHSPC patients, focusing on prostate-specific antigen (PSA) kinetics, safety, and survival outcomes.

methodA retrospective, single-centre study included 107 chemotherapy-naïve mHSPC patients treated with abiraterone or apalutamide plus ADT. PSA levels were measured at baseline and during treatment. Primary outcomes were PSA progression-free survival (PSA-PFS) and overall survival (OS). Adverse events were recorded. Inverse probability treatment weighting adjusted baseline differences.

resultsMedian PSA-PFS significantly favoured apalutamide (log-rank p = 0.015). Achieving PSA ≤ 0.02 ng/mL was strongly associated with delayed progression (HR 0.07, 95% CI 0.02-0.28; p < 0.001). OS did not differ significantly between groups (p = 0.504). Apalutamide achieved lower median nadir PSA (0.02 ng/mL vs. 0.23 ng/mL, p < 0.001) and shorter mean time to nadir (4.5 vs. 7.2 months, p = 0.001), with more patients reaching ultralow PSA levels (≤ 0.02 ng/mL) during follow-up. Adverse events occurred more frequently with apalutamide (71.2% vs. 46.5%, p = 0.015), with fatigue and rash being the most common.

conclusionApalutamide demonstrated deeper and more sustained PSA reductions, translating into delayed disease progression compared to abiraterone. Both treatments were generally well tolerated, though adverse events were more prevalent with apalutamide.

Indexed as

Androgen AntagonistsAndrostenesAntineoplastic Combined Chemotherapy ProtocolsProstatic NeoplasmsThiohydantoinsAbiraterone AcetateAgedAged, 80 and overHumansMaleMiddle AgedProgression-Free SurvivalProstate-Specific AntigenRetrospective StudiesTreatment OutcomeabirateroneAbiraterone AcetateAndrogen AntagonistsAndrostenesapalutamideProstate-Specific AntigenThiohydantoinsAbirateroneAntineoplastic agentsApalutamideProstate-specific antigenProstatic neoplasms

Identifiers

PMID40327314
PMCPMC12630208

What OpenQuestion holds

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Registered trials

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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.