Page 13 - PACE: Advanced Prostate Cancer Consensus

Treatment Beyond ADT Provides ~Two-year Increase

in Metastasis-Free Survival (MFS)

Apalutamide (SPARTAN) 1 Enzalutamide (PROSPER) 2 Darolutamide (ARAMIS) 3

Median MFS Median MFS Median MFS
100 APA + ADT: 40.5 mo 100 ENZA + ADT: 36.6 mo 1.0 DARO + ADT: 40.4 mo
PBO + ADT: 18.4 mo
PBO + ADT: 14.7 mo
PBO + ADT: 16.2 mo
90
90
Metastasis-free survival (%) 70 Placebo + Apalutamide + ADT Metastasis-free survival (%) 70 Placebo + Enzalutamide + ADT Metastasis-free survival probability 0.7 Darolutamide + ADT
0.9
80
80
0.8
60
60
0.6
50
50
0.5
40
40
0.4
30
30
0.3
ADT
ADT
20
10
10
0.1
ADT
p <0.001
p <0.0001
p <0.001
0 HR, 0.28 (95% Cl, 0.23–0.35) 20 0 HR, 0.29 (95% CI, 0.24–0.35) 0.2 HR, 0.41 (95% CI, 0.34–0.50) Placebo +
0.0
0 4 8 12 16 20 24 28 32 36 40 44 0 3 6 9 12 15 18 21 24 27 30 33 36 39 42 0 4 8 12 16 20 24 28 32 36 40 44 48
Months Months Months
No. at risk No. at risk No. at risk
APA + ADT 803 713 652 514 398 282 180 96 36 16 3 0 ENZA + ADT 933 865 759 637 528 431 418 328 237 159 87 77 31 4 0 DARO + ADT 955 817 675 506 377 262 189 116 68 37 18 2 0
PBO + ADT 401 291 220 153 91 58 34 13 5 1 0 0 PBO + ADT 468 420 296 212 157 105 98 64 49 31 16 11 5 1 0 PBO + ADT 554 368 275 180 117 75 50 29 12 4 0 0 0
Delayed metastases by two years
APA, apalutamide; CI, confidence interval; DARO, darolutamide; ENZA, enzalutamide; HR, hazard ratio; PBO, placebo
Slide provided by Dr. Saad.
1. Smith MR, et al. N Engl J Med 2018;378:1408-1418; 2. Hussain M, et al. N Engl J Med 2018;378:2465-2474; 3. Fizazi K, et al. N Engl J
Med 2019;380:1235-1246. [Epub ahead of print]