Comparison of deep prostate-specific antigen response in Black patients with metastatic castration-sensitive prostate cancer initiated on apalutamide or enzalutamide

Aim: There is limited real-world evidence about prostate-specific antigen (PSA) response to androgen receptor pathway inhibitor treatment in Black patients with metastatic castration-sensitive prostate cancer (mCSPC). This study compared PSA90 (≥90% reduction from baseline PSA level) between apalutamide and enzalutamide among Black patients with mCSPC. Materials p = 0.020). Median time to first PSA90 response was shorter among patients treated with apalutamide (3.3 months) compared with enzalutamide (5.5 months). Conclusion: In Black patients with mCSPC, apalutamide led to faster and significantly deeper PSA responses than enzalutamide, suggesting potential clinical advantages in optimizing early treatment response in this population. Future research should assess PSA90 as a prognostic indicator of overall survival among Black patients.