{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:38:25Z","timestamp":1787027905544,"version":"build-2736575974"},"reference-count":38,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T00:00:00Z","timestamp":1740096000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Current Oncology"],"abstract":"<jats:p>Background: The management of metastatic hormone-sensitive prostate cancer (mHSPC) has evolved significantly in recent years due to the introduction of androgen receptor-targeted agents (ARTAs). When used alongside androgen deprivation therapy (ADT), these treatments have shown improved oncological results and enhanced survival rates for patients with this condition. Objectives: The objective of this study was to describe the decline in prostate-specific antigen (PSA), the oncological outcomes, and the toxicity profile of mHSPC patients treated with apalutamide. Materials and Methods: Clinical data obtained from seven national hospitals were utilized between March 2021 and July 2024. PSA responses were collected at 3, 6, 12, 18, and 24 months, along with adverse effects reported by patients, dose reductions, or drug discontinuations. The association between PSA decline and progression-free survival (PFS) was evaluated with respect to metastasis volume, location, and timing of diagnosis. Results: A total of 432 patients were included, of whom 40% were de novo cases, and the greater part were classified as M1b. After one year, a reduction of more than 90% in PSA levels was observed in 88.2% of cases, with undetectable levels (\u22640.2 ng\/mL) achieved in 81.7% of them. The drug was discontinued in 76 patients (15.6%), with adverse effects reported in 7.8% (grade 3) and 1.9% (grade 4). Regarding PSA levels &lt;0.02 ng\/mL, promising results were observed, with ultralow PSA (UL2) achieved in 43% of cases at 6 months. Conclusions: This study revealed strong oncological outcomes, with rapid and profound PSA declines and drug safety consistent with emerging evidence. The distinctive finding of this study underscores the importance of a rapid and profound response (UL PSA) as a predictor of better oncological outcomes.<\/jats:p>","DOI":"10.3390\/curroncol32030119","type":"journal-article","created":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T10:12:11Z","timestamp":1740132731000},"page":"119","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Multicenter Real-World Study: 432 Patients with Apalutamide in Metastatic Hormone-Sensitive Prostate Cancer"],"prefix":"10.3390","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1463-9326","authenticated-orcid":false,"given":"Juan A.","family":"Encarnaci\u00f3n Navarro","sequence":"first","affiliation":[{"name":"Department Radiation Oncology, Hospital Cl\u00ednico Universitario Virgen de la Arrixaca, 30120 Murcia, Spain"},{"name":"Faculty of Medicine, University of Murcia, 30100 Murcia, Spain"},{"name":"Murcian Institute of Biosanitary Research, 30120 Murcia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3102-9001","authenticated-orcid":false,"given":"Virginia","family":"Morillo Mac\u00edas","sequence":"additional","affiliation":[{"name":"Department Radiation Oncology, Consorcio Hospitalario Provincial, 12002 Castell\u00f3n, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda","family":"Borr\u00e1s Calbo","sequence":"additional","affiliation":[{"name":"Department Radiation Oncology, Hospital Universitario y Polit\u00e9cnico La Fe, 46026 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabel","family":"De la Fuente Mu\u00f1oz","sequence":"additional","affiliation":[{"name":"Department Radiation Oncology, Hospital Cl\u00ednico Universitario Virgen de la Arrixaca, 30120 Murcia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Lozano Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Department Radiation Oncology, Hospital Cl\u00ednico Universitario Virgen de la Arrixaca, 30120 Murcia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vicente","family":"Garc\u00eda Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Department Radiation Oncology, Hospital General Universitario Santa Luc\u00eda, 30202 Cartagena, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis","family":"Fern\u00e1ndez Fornos","sequence":"additional","affiliation":[{"name":"Department Radiation Oncology, Hospital Universitario San Juan, 03550 Alicante, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam","family":"Guijarro Roche","sequence":"additional","affiliation":[{"name":"Department Radiation Oncology, Hospital Universitario San Juan, 03550 Alicante, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osamah","family":"Amr Rey","sequence":"additional","affiliation":[{"name":"Department Radiation Oncology, Consorcio Hospital General Universitario, 46014 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3797-4717","authenticated-orcid":false,"given":"Raquel","family":"Garc\u00eda G\u00f3mez","sequence":"additional","affiliation":[{"name":"Department Radiation Oncology, Hospital Cl\u00ednico Universitario, 15706 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,2,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1749","DOI":"10.1001\/jamaoncol.2019.2996","article-title":"Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-Adjusted life-years for 29 cancer groups, 1990 to 2017: A systematic analysis for the global burden of disease study","volume":"5","author":"Fitzmaurice","year":"2019","journal-title":"JAMA Oncol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"209","DOI":"10.3322\/caac.21660","article-title":"Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA Cancer J. 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