As reported in the Journal of Clinical Oncology by Kim N. Chi, MD, and colleagues, the final overall survival analysis of the phase III TITAN trial showed significant benefit with apalutamide plus androgen-deprivation therapy vs placebo plus androgen-deprivation therapy in patients with metastatic castration-sensitive prostate cancer, both without and with adjustment for significant crossover to apalutamide from the placebo group.

In a study reported in JCO Oncology Practice, Lai et al found that although the majority of men who have initiated active surveillance for prostate cancer are followed by urologists, some are managed by physicians in other specialties, and that testing and subsequent treatment patterns vary across those specialties.

In the ENACT study, reported in the Journal of Clinical Oncology, Murphy et al found that use of the 12-gene Genomic Prostate Score in a predominantly Black patient population with relatively low-risk prostate cancer tended to be associated with reduced selection of active surveillance over treatment—primarily among men with lower health literacy.

Various genetic alterations in circulating tumor cells (CTCs) were associated with clinical outcomes and resistance to hormone therapy in patients with metastatic castration-resistant prostate cancer, according to research published by Gupta et al in Molecular Cancer Research.

According to a retrospective study, the combined clinical and cell-cycle risk (CCR) score may be able to accurately predict which patients with intermediate- and high-risk prostate cancer will have little additional benefit from androgen-deprivation therapy added to dose-escalated radiotherapy and which patients should be treated with both therapeutic modalities. The ability to decide which patients need intensified therapy based on a validated tool such as CCR may optimize therapeutic decision-making, spare some patients from the side effects of androgen-deprivation therapy, and reduce the costs of therapy.