Update: FDA Approves Apalutamide (Erleada) for Metastatic Castration-Sensitive Prostate Cancer

Hi, I’m Dr. Scholz. I want to talk to you a little bit about a
new indication for a medicine called apalutadmide, otherwise known as Erleada. Erleada is a powerful
second-generation hormonal agent that is very effective for advanced prostate cancer. Historically,
it’s been approved only for men that have become resistant to Lupron, but a new indication
now is available and this is due to a large 1000-member prospective trial showing better
survival and better outcomes in men who add Erleada to Lupron at the inception of their
Lupron treatment. So, this category of men should be less common,
but unfortunately, it is fairly common. We’re talking about prostate in men that pretty
much neglected to check their PSA levels. These individuals have castrate sensitive
prostate cancer and metastatic disease as well. So what this means, usually, is they
didn’t check their PSAs and their PSAs went to very high levels, the cancer spread, and
then when some pain developed they went to the doctors and they found the cancer after
it had already spread. So it’s in the group of men that Erleada has been shown to prolong
survival because historically men would either be treated just with Lupron, or possibly with
Lupron plus chemotherapy (such as Taxotere), or possibly with Lupron plus Zytiga. Zytiga
being another type of second-generation hormonal therapy. So this is good news for men that
are in this category. The Erleada medication is well-tolerated. There’s sometimes men will
have a little bit of a rash with it, but it doesn’t add much in terms of side effects.
It just prolongs survival and results in better outcomes. So, be aware of that for those of
you that have metastatic disease, but have not resistant to Lupron. Erleada may be an
excellent choice for you.

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