{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,14]],"date-time":"2026-03-14T02:35:44Z","timestamp":1773455744518,"version":"3.50.1"},"reference-count":19,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2025,2,2]],"date-time":"2025-02-02T00:00:00Z","timestamp":1738454400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,6,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To evaluate the real-world clinical usage and effectiveness of apalutamide in men with nonmetastatic castration-resistant prostate cancer (nmCRPC).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We retrospectively reviewed the data of 186 men who received apalutamide across 17 institutions. The primary outcomes were the clinical usage of apalutamide for nmCRPC: prior usage of other androgen receptor signaling inhibitors (ARSIs), prior radical treatment, and the distribution of the prostate-specific antigen (PSA) doubling time (PSA-DT) at the initial administration of apalutamide. The secondary outcomes were the efficacy of apalutamide: PSA response (50% or 90% decline), progression-free survival, and skin-adverse events (AEs).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We identified 75 patients with nmCRPC. A total of 31 (41.3%) patients received prior treatment with other ARSIs. A total of 42 men (56%) did not receive any prior radical treatment. The PSA-DT was &amp;lt;3.0, 3.0\u20135.9, 6.0\u201310, and\u00a0&amp;gt;\u00a010\u00a0months in 34.7%, 40%, 14.7%, and 10.6% of the patients, respectively. Patients receiving prior treatment with other ARSIs showed a significantly lower PSA response (PSA 50% decline, 88.4% vs. 18.8%; PSA 90% decline, 60.5% vs. 6.2%, P\u00a0&amp;lt;\u00a0.001, respectively) and significantly shorter progression-free survival (median: 37\u00a0months vs. 4\u00a0months; log-rank P\u00a0&amp;lt;\u00a0.001) than those without prior ARSI treatment, although cancer status did not differ between the groups. Skin-AEs were observed in 42.7%.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>This real-world study revealed that apalutamide was used for the treatment after other ARSIs in &amp;gt;40% of patients with nmCRPC and showed limited efficacy in this context, although the effectiveness of apalutamide without prior other ARSI treatment was comparable with that reported in clinical trial results.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jjco\/hyaf025","type":"journal-article","created":{"date-parts":[[2025,2,2]],"date-time":"2025-02-02T14:22:16Z","timestamp":1738506136000},"page":"643-649","source":"Crossref","is-referenced-by-count":2,"title":["Real-world clinical usage and efficacy of apalutamide in men with nonmetastatic castration-resistant prostate cancer: a multi-institutional study in the CsJUC"],"prefix":"10.1093","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3884-8915","authenticated-orcid":false,"given":"Yoichiro","family":"Tohi","sequence":"first","affiliation":[{"name":"Department of Urology, Faculty of Medicine, Kagawa University , 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa 761-0793 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keita","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Department of Urology, Graduate School of Medicine, Yamaguchi University , 1-1-1, Minami-Kogushi, Ube, Yamaguchi 755-8505 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kei","family":"Daizumoto","sequence":"additional","affiliation":[{"name":"Department of Urology, Tokushima University Graduate School of Biomedical Sciences , 3-18- 15 Kuramoto, Tokushima 770-8503,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yohei","family":"Sekino","sequence":"additional","affiliation":[{"name":"Department of Urology, Graduate School of Biomedical and Health Sciences, Hiroshima University , 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9692-0239","authenticated-orcid":false,"given":"Hideo","family":"Fukuhara","sequence":"additional","affiliation":[{"name":"Department of Urology, Kochi Medical School , 185-1, Kohasu, Oko, Nankoku, Kochi 783-8505 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heima","family":"Niigawa","sequence":"additional","affiliation":[{"name":"Department of Urology, Kawasaki Medical School , 577, Matsushima, Kurashiki, Okayama 701-0192 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8377-2457","authenticated-orcid":false,"given":"Satoshi","family":"Katayama","sequence":"additional","affiliation":[{"name":"Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences , 2-5-1 Shikata-Cho, Kita-Ku, Okayama 700-8558 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryutaro","family":"Shimizu","sequence":"additional","affiliation":[{"name":"Division of Urology, Department of Surgery, Faculty of Medicine, Tottori University, 86 Nishi-cho, Yonago, Tottori 683-8503 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atsushi","family":"Takamoto","sequence":"additional","affiliation":[{"name":"Department of Urology, Fukuyama City Hospital , 5-23-1, Zao, Fukuyama, Hiroshima 720-8505 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Department of Surgery, Faculty of Medicine, Tottori University, 86 Nishi-cho, Yonago, Tottori 683-8503 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noriyoshi","family":"Miura","sequence":"additional","affiliation":[{"name":"Department of Urology, Ehime University , 454, Shitsukawa, Toon, Ehime 791-0295 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koichiro","family":"Wada","sequence":"additional","affiliation":[{"name":"Department of Urology , Shimane University Faculty of Medicine, Shimane,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9266-782X","authenticated-orcid":false,"given":"Mikio","family":"Sugimoto","sequence":"additional","affiliation":[{"name":"Department of Urology, Faculty of Medicine, Kagawa University , 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa 761-0793 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