Skin rash in metastatic hormone sensitive prostate cancer patients treated with apalutamide: a retrospective multicenter study in Korea
Year: 2024
Type: article
Study design: Observational Study
Abstract: Background: Skin rash is a common adverse event in patients with metastatic hormone-sensitive prostate cancer (mHSPC) treated with apalutamide. This study aims to investigate the incidence rate of skin rash and the predictive value of inflammation markers for skin rash in real-world Korean patients. Materials and Methods: We conducted a retrospective analysis of patients with prostate cancer (PCa) who received apalutamide across 18 institutions in Korea, with a follow-up period of at least three months. A total of 218 patients were evaluated. Results: Among the 214 patients analyzed, 78 (36.4%) developed a skin rash. The severity of the rash was classified as grade 1 (G1) in 27 patients (12.6%), grade 2 (G2) in 29 patients (13.5%), and grade 3 (G3) in 22 patients (10.3%). The median time to onset of any skin rash was 65.5 days (interquartile range, IQR 31.0-88.0). The monocyte-to-lymphocyte ratio (MLR) and systemic immune-inflammation response index (SIRI) were significantly higher in the G2 plus G3 group compared to the no rash plus G1 group (p=0.006, p=0.013, respectively) before apalutamide treatment. After 3 months, platelet-to-lymphocyte ratio (PLR) and SIRI were significantly higher in the G2 plus G3 group compared to the no rash plus G1 group (p=0.010, p=0.025, respectively). Conclusions: In a real-world cohort of Korean patients, skin rash occurred in 36.4% of cases, with a median time to onset of 65.5 days. Grade 3 skin rash developed in 10.3% of cases. While MLR and SIRI were significantly higher in the G2 plus G3 group, these markers cannot be considered reliable predictors due to a low area under the curve (AUC < 0.7) before apalutamide treatment. However, increased levels of PLR, SII, and SIRI could potentially be useful for monitoring for the risk of severe rash development in these patients.
Source: Prostate International
Authors: Won Tae Kim, Hyun Ho Han, Seok Joong Yun, Seong Hyeon Yu, Taek Won Kang, Yun-Sok Ha, Jun Nyung Lee, Tae Gyun Kwon, Byung Hoon Kim, Won Ik Seo, Chan Ho Lee, Jae Il Chung, Jung Ki Jo, U-Syn Ha, Ji Youl Lee, Hwang Gyun Jeon, Seong Il Seo, Kyo Chul Koo, Byung Ha Chung, Jong Wook Kim, Joongwon Choi, Jong Wook Park, Hongzoo Park, Sungchan Park, Soo Dong Kim, Hak Min Lee, Sung Kyu Hong, Jae Young Joung
Institutions: Chungbuk National University, Chungbuk National University Hospital, Yonsei University, Chonnam National University, Chonnam National University Hospital, Kyungpook National University, The Catholic University of Korea Seoul St. Mary's Hospital, Catholic University of Korea, Keimyung University Dongsan Hospital, Keimyung University, Inje University, Inje University Busan Paik Hospital, Hanyang University, Samsung Medical Center, Sungkyunkwan University, Yonsei University Health System, Korea University Guro Hospital, Kangwon National University, Kangwon National University Hospital, University of Ulsan, Ulsan University Hospital, Dong-A University Hospital, Dong-A University, Seoul National University, Seoul National University Bundang Hospital, National Cancer Center
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $1,800
OpenAlex ID: W4404083162