Impact of a rash management guide in patients receiving apalutamide for high-risk localized prostate cancer in the Apa-RP study

Background/objectives Based on the SPARTAN and TITAN studies, apalutamide is approved for patients with nonmetastatic castration-resistant and metastatic castration-sensitive prostate cancer. Skin rash was a common adverse reaction across indications. We hypothesized that earlier identification and intervention could improve rash outcomes. Subjects/methods A prespecified rash management guide outlining recommended skin care practices was provided to all patients enrolled in Apa-RP (NCT04523207). Rash-related safety data from Apa-RP were compared descriptively with data from SPARTAN and TITAN. Results Patients in Apa-RP experienced improved rash-related outcomes vs those in SPARTAN and TITAN. Conclusions Increased vigilance and proactive management may reduce the incidence, severity, and duration of rash during apalutamide treatment.