{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T08:52:36Z","timestamp":1793436756763,"version":"4.5.0"},"reference-count":28,"publisher":"Becaris Publishing Limited","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Comp. Eff. Res."],"abstract":"<jats:p>\n            <jats:bold>Aim:<\/jats:bold>\n            Head-to-head studies of survival outcomes associated with different androgen receptor pathway inhibitor (ARPI) treatments for metastatic castration (hormone)-sensitive prostate cancer have not been conducted. The purpose of this study was to compare 24-month overall survival among ARPI-naive patients with metastatic castration-sensitive prostate cancer (mCSPC) who initiated apalutamide or abiraterone acetate.\n            <jats:bold>Materials &amp; methods:<\/jats:bold>\n            Linked de-identified clinical and claims healthcare databases were used to compare overall survival between patients with mCSPC initiating apalutamide or abiraterone acetate treated in community-based urology practices in the USA. Overall survival at 24\u00a0months post-treatment initiation (primary analyses) was compared between apalutamide and abiraterone acetate initiators using weighted Cox proportional hazards models (exploratory analyses used all available follow-up).\n            <jats:bold>Results:<\/jats:bold>\n            Overall, 1879 and 2073 patients had initiated apalutamide or abiraterone acetate, respectively (both cohorts: weighted mean age 72\u00a0years, 62% were white, and 66% had bone metastasis). At 24 months post-index, patients in the apalutamide cohort had a 26% lower risk of mortality compared with those in the abiraterone acetate cohort (hazard ratio: 0.74; 95% confidence interval: 0.59, 0.93; p\u00a0=\u00a00.010), with the difference maintained when outcomes were evaluated using all available follow-up (hazard ratio: 0.72; 95% confidence interval: 0.59, 0.88; nominal p\u00a0&lt;\u00a00.001).\n            <jats:bold>Conclusion:<\/jats:bold>\n            In this nationally representative, real-world head-to-head analysis of nearly 4000 ARPI-naive patients with mCSPC, apalutamide was associated with a 26% reduction in the risk of mortality compared with abiraterone acetate by 24\u00a0months post-treatment initiation.\n          <\/jats:p>","DOI":"10.57264\/cer-2025-0023","type":"journal-article","created":{"date-parts":[[2025,5,9]],"date-time":"2025-05-09T12:14:12Z","timestamp":1746792852000},"source":"Crossref","is-referenced-by-count":11,"title":["Overall survival in patients with metastatic castration-sensitive prostate cancer treated with apalutamide versus abiraterone acetate: a head-to-head analysis of real-world patients in the USA"],"prefix":"10.57264","author":[{"given":"Benjamin","family":"Lowentritt","sequence":"first","affiliation":[{"name":"Chesapeake Urology, Towson, MD 21204, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehmet A","family":"Bilen","sequence":"additional","affiliation":[{"name":"Winship Cancer Institute of Emory University, Atlanta, GA 30322, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ibrahim","family":"Khilfeh","sequence":"additional","affiliation":[{"name":"Johnson &amp; Johnson, Horsham, PA 19044, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmine","family":"Rossi","sequence":"additional","affiliation":[{"name":"Analysis Group, Inc., Montr\u00e9al, QC H3B 0G7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shawn","family":"Du","sequence":"additional","affiliation":[{"name":"Johnson &amp; Johnson, Horsham, PA 19044, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederic","family":"Kinkead","sequence":"additional","affiliation":[{"name":"Analysis Group, Inc., Montr\u00e9al, QC H3B 0G7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lilian","family":"Diaz","sequence":"additional","affiliation":[{"name":"Analysis Group, Inc., Montr\u00e9al, QC H3B 0G7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominic","family":"Pilon","sequence":"additional","affiliation":[{"name":"Analysis Group, Inc., Montr\u00e9al, QC H3B 0G7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorie","family":"Ellis","sequence":"additional","affiliation":[{"name":"Johnson &amp; Johnson, Horsham, PA 19044, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neal D","family":"Shore","sequence":"additional","affiliation":[{"name":"Carolina Urologic Research Center, Myrtle Beach, SC 29572, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"36897","published-online":{"date-parts":[[2025,5,9]]},"reference":[{"issue":"2","key":"e_1_3_11_2_2","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1007\/s40487-020-00119-z","article-title":"Metastatic hormone-sensitive prostate cancer (mHSPC): advances and treatment strategies in the first-line setting","volume":"8","author":"Ng K","year":"2020","unstructured":"Ng K, Smith S, Shamash J. Metastatic hormone-sensitive prostate cancer (mHSPC): advances and treatment strategies in the first-line setting. Oncol. Ther. 8(2), 209\u2013230 (2020).","journal-title":"Oncol. Ther."},{"issue":"9","key":"e_1_3_11_3_2","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1007\/s11864-019-0668-8","article-title":"Management of metastatic hormone-sensitive prostate cancer (mHSPC): an evolving treatment paradigm","volume":"20","author":"Weiner AB","year":"2019","unstructured":"Weiner AB, Nettey OS, Morgans AK. Management of metastatic hormone-sensitive prostate cancer (mHSPC): an evolving treatment paradigm. Curr. Treat. Options Oncol. 20(9), 69 (2019).","journal-title":"Curr. Treat. Options Oncol."},{"issue":"8","key":"e_1_3_11_4_2","doi-asserted-by":"crossref","first-page":"T19","DOI":"10.1530\/ERC-21-0098","article-title":"Androgen receptor signaling inhibitors: post-chemotherapy, pre-chemotherapy and now in castration-sensitive prostate cancer","volume":"28","author":"Mitsiades N","year":"2021","unstructured":"Mitsiades N, Kaochar S. Androgen receptor signaling inhibitors: post-chemotherapy, pre-chemotherapy and now in castration-sensitive prostate cancer. Endocr. Relat. Cancer 28(8), T19\u2013T38 (2021).","journal-title":"Endocr. Relat. Cancer"},{"issue":"1","key":"e_1_3_11_5_2","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1056\/NEJMoa1903307","article-title":"Apalutamide for metastatic, castration-sensitive prostate cancer","volume":"381","author":"Chi KN","year":"2019","unstructured":"Chi KN, Agarwal N, Bjartell A Apalutamide for metastatic, castration-sensitive prostate cancer. N. Engl. J. Med. 381(1), 13\u201324 (2019).","journal-title":"N. Engl. J. Med."},{"issue":"20","key":"e_1_3_11_6_2","doi-asserted-by":"crossref","first-page":"2294","DOI":"10.1200\/JCO.20.03488","article-title":"Apalutamide in patients with metastatic castration-sensitive prostate cancer: final survival analysis of the randomized, double-blind, Phase III TITAN study","volume":"39","author":"Chi KN","year":"2021","unstructured":"Chi KN, Chowdhury S, Bjartell A Apalutamide in patients with metastatic castration-sensitive prostate cancer: final survival analysis of the randomized, double-blind, Phase III TITAN study. J. Clin. Oncol. 39(20), 2294\u20132303 (2021).","journal-title":"J. Clin. Oncol."},{"key":"e_1_3_11_7_2","unstructured":"United States Food and Drug Administration. FDA approves apalutamide for metastatic castration-sensitive prostate cancer. Accessed: 29 July 2024: https:\/\/www.fda.gov\/drugs\/resources-information-approved-drugs\/fda-approves-apalutamide-metastatic-castration-sensitive-prostate-cancer"},{"issue":"4","key":"e_1_3_11_8_2","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1056\/NEJMoa1704174","article-title":"Abiraterone plus prednisone in metastatic, castration-sensitive prostate cancer","volume":"377","author":"Fizazi K","year":"2017","unstructured":"Fizazi K, Tran N, Fein L Abiraterone plus prednisone in metastatic, castration-sensitive prostate cancer. N. Engl. J. Med. 377(4), 352\u2013360 (2017).","journal-title":"N. Engl. J. 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Urol."},{"issue":"5","key":"e_1_3_11_12_2","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1016\/j.annonc.2023.02.009","article-title":"Deep, rapid, and durable prostate-specific antigen decline with apalutamide plus androgen deprivation therapy is associated with longer survival and improved clinical outcomes in TITAN patients with metastatic castration-sensitive prostate cancer","volume":"34","author":"Chowdhury S","year":"2023","unstructured":"Chowdhury S, Bjartell A, Agarwal N Deep, rapid, and durable prostate-specific antigen decline with apalutamide plus androgen deprivation therapy is associated with longer survival and improved clinical outcomes in TITAN patients with metastatic castration-sensitive prostate cancer. Ann. Oncol. 34(5), 477\u2013485 (2023).","journal-title":"Ann. Oncol."},{"issue":"2","key":"e_1_3_11_13_2","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1016\/j.eururo.2021.11.020","article-title":"Deep prostate-specific antigen response following addition of apalutamide to ongoing androgen deprivation therapy and long-term clinical benefit in SPARTAN","volume":"81","author":"Saad F","year":"2022","unstructured":"Saad F, Small EJ, Feng FY Deep prostate-specific antigen response following addition of apalutamide to ongoing androgen deprivation therapy and long-term clinical benefit in SPARTAN. Eur. Urol. 81(2), 184\u2013192 (2022).","journal-title":"Eur. Urol."},{"issue":"6","key":"e_1_3_11_14_2","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1200\/JCO.2021.39.6_suppl.94","article-title":"Overall survival (OS) and metastasis-free survival (MFS) by depth of prostate-specific antigen (PSA) decline in the Phase III PROSPER trial of men with nonmetastatic castration-resistant prostate cancer (nmCRPC) treated with enzalutamide (ENZA)","volume":"39","author":"Hussain MHA","year":"2021","unstructured":"Hussain MHA, Sternberg CN, Efstathiou E Overall survival (OS) and metastasis-free survival (MFS) by depth of prostate-specific antigen (PSA) decline in the Phase III PROSPER trial of men with nonmetastatic castration-resistant prostate cancer (nmCRPC) treated with enzalutamide (ENZA). J. Clin. Oncol. 39(Suppl. 6), 94 (2021).","journal-title":"J. Clin. 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