ORIGINAL RESEARCH article
Front. Oncol.
Sec. Genitourinary Oncology
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1656216
This article is part of the Research TopicAdvancements in targeted therapies for genitourinary cancersView all 4 articles
Efficacy and safety of apalutamide, abiraterone acetate, and bicalutamide in the treatment of metastatic hormone-sensitive prostate cancer
Provisionally accepted
- 1Affiliated Hospital of North Sichuan Medical College, Nanchong, China
- 2Deyang Hospital affiliated to Chengdu University of Traditional Chinese Medicine, Deyang, China
- 3Dazhou Dachuan District People's Hospital, Dazhou, China
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Objectives: To compare the efficacy and safety of three drugs—Apalutamide, Abiraterone, and Bicalutamide—combined with Androgen Deprivation Therapy (ADT) in patients with metastatic hormone-sensitive prostate cancer (mHSPC). Methods: We retrospectively collected survival data of patients treated at our hospital from January 2019 to March 2024. Patients who received three different treatment regimens—Apalutamide (240 mg/day) combined with ADT, Abiraterone (1000 mg/day) plus Prednisone (5 mg/day) combined with ADT, and Bicalutamide (50 mg/day) combined with ADT. Results: This study analyzed 146 mHSPC patients. The results are displayed that Apalutamide and Abiraterone significantly prolonged PFS and PSA-PFS compared to Bicalutamide. Univariate and multivariate COX regression analyses suggested that factors such as age <75 years, absence of lymph node metastasis, use of Apalutamide or Abiraterone, and a low ECOG score were associated with longer PFS. Moreover, Apalutamide and Abiraterone showed superior efficacy in improving PSA response compared to Bicalutamide. Importantly, no life-threatening adverse events were reported in any of the three treatment groups. Conclusion: Compared to Bicalutamide, the novel endocrine therapies Apalutamide and Abiraterone both significantly prolong PFS, PSA-PFS, and improve PSA response rates.
Keywords: Apalutamide, abiraterone acetate, Bicalutamide, prostate cancer, Endocrine therapy, androgen deprivation therapy
Received: 29 Jun 2025; Accepted: 25 Sep 2025.
Copyright: © 2025 Zhang, Wang, Zhou, Gao, Hao and Wu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Tao Wu, alhawking@nsmc.edu.cn
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