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Conclusions
•
M0 CRPC is a
heterogeneous
disease. High risk M0 CRPC can be identified by PSA-
DT.
•
M0 CRPC pts with PSA-DT <8-10m are at
high risk
of metastases or death.
•
Apalutamide
decreases the risk of M1 or death by 72%, and delays the appearance
of M1 in >2 years in men with high-risk M0 CRPC.
•
Enzalutamide
decreases the risk of M1 or death by 71%, and delays the appearance
of M1 in 1.8 years in men with high-risk M0 CRPC.
•
The 2
first
randomised phases III trials to show a survival benefit in this setting.
•
MFS is a potential surrogate marker for OS in M0 CRPC.
•
These are
practice-changing
new
standard of care
options.