Apalutamide-Induced Drug Reaction With Eosinophilia and Systemic Symptoms (DRESS) Syndrome in a Patient With Metastatic Prostate Cancer: A Case Report
Year: 2026
Type: article
Study design: Case Report
Abstract: Metastatic prostate cancer is a leading cause of cancer-related morbidity and mortality. Androgen deprivation therapy (ADT) remains the foundation of systemic treatment, with novel androgen receptor inhibitors such as apalutamide increasingly used in patients with metastatic hormone-sensitive prostate cancer (mHSPC). Apalutamide is generally well tolerated. Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is not recognized as an established side effect of apalutamide. We report the case of a man in his seventies who was initiated on apalutamide for mHSPC. Ten days after initiation, he developed a widespread maculopapular rash accompanied by biochemical abnormalities. Clinical assessment suggested a diagnosis of DRESS syndrome, most consistent with the criteria of Bocquet et al. The patient was managed with immediate discontinuation of apalutamide and initiation of high-dose systemic corticosteroids. He improved clinically and biochemically and subsequently transitioned to enzalutamide. This case highlights the importance of recognizing rare but potentially life-threatening adverse reactions associated with apalutamide.
Source: Cureus
Authors: Shawly Kabir, Lynne Cormode
Institution: Ninewells Hospital
Language: English
Subfield: Pharmacology (medical)
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7221560897