Erleada

Erleada

Generic Name

Erleada

Mechanism

  • Selective AR binding: Apalutamide competitively inhibits ligand binding to the intracellular AR domain, blocking androgen‑induced conformational change.
  • Inhibition of AR nuclear translocation: Prevents AR dimerization and passage of the AR‑ligand complex into the nucleus.
  • Suppression of AR target gene transcription: Decreases expression of genes driving prostate‑cell proliferation (e.g., PSA, PSA‑related proteins).
  • High potency and no partial agonist activity: Provides >10‑fold stronger inhibition than first‑generation AR blockers (bicalutamide) without the anabolic side‑effects seen in androgen deprivation alone.

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Pharmacokinetics

ParameterTypical valuesComment
Absorption~81 % oral bioavailability (≈ 5 mg/kg dose). Peak plasma concentration (Cmax) ~ 106 ng/mL at 6–8 h.Enhanced by food (~1.5×).
DistributionHighly protein‑bound (~ 99 %), extensive tissue penetration (especially prostate).Blood‑brain barrier penetration minimal.
MetabolismPrimarily CYP2C9, CYP3A4, and CYP2C19 convert apalutamide to active metabolites (≥ 50% of exposure). Minor pathway via CYP3A4/2C9 → glucuronidation.Metabolites have ~10‑fold less activity.
Half‑life∼ 30 h (terminal).Allows daily dosing.
Excretion70–80 % fecal (biliary), 10–15 % renal.Dose adjustment not required for mild‑moderate renal impairment.
Drug interactionsInhibitors/inducers of CYP2C9 or CYP3A4 can alter apalutamide levels. Avoid A**; (e.g., clarithromycin, rifampicin).Use of strong CYP3A4 inducers may reduce efficacy.

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Indications

IndicationApproved Dose & ScheduleAdditional Notes
Metastatic CRPC (with castrate testosterone ≤ 0.5 ng/mL)240 mg orally once daily (tablet or oral suspension)Can be used as first‑line therapy pre‑docetaxel or post‑docetaxel.
High‑risk non‑metastatic CRPC (SPARTACUS criteria)240 mg orally once dailyShowed 99 % reduction in time to metastasis; extends overall survival.

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Contraindications

  • Contraindicated
  • Hypersensitivity to apalutamide or any excipient.
  • Pregnant or nursing women (teratogenic potential).
  • Warnings
  • QT prolongation – baseline ECG recommended; avoid concomitant QT‑prolonging drugs (e.g., azithromycin, haloperidol).
  • Hepatic impairment – monitor LFTs; dose adjustment otherwise not required.
  • Osteoporotic fractures – AR blockade can reduce bone mineral density; consider bone‑protective agents for long‑term therapy.
  • Precautions
  • Elderly patients may exhibit more pronounced edema; monitor electrolytes.
  • Tamoxifen, tamox; no evidence for pregnancy risk beyond general precautions.

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Dosing

  • Adult: *240 mg* once daily, preferrably with a light meal to maximize absorption.
  • Formulation: 4 × 60 mg tablets or 120 mg oral suspension.
  • Start‑up: No dose ramp‑up necessary; begin full dose immediately.
  • Compliance: Reinforce once‑daily schedule; endorse patient diaries or phone reminders.

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Adverse Effects

  • Common (≥10 %)
  • Edema (particularly lower limbs)
  • Fatigue / asthenia
  • Hot flashes
  • Hypertension (≤ 5 % serious)
  • Nausea / GI upset
  • Serious (≥1 %)
  • Severe edema with respiratory compromise
  • QTc prolongation (> 500 ms) → arrhythmias
  • Hepatotoxicity (transaminitis, cholestatic pattern)
  • Acute eye events (retinal vascular occlusion)
  • Severe candida infections (rare)
  • Discontinuation: For unmanageable or progressive edema, worsening QTc, or transaminitis > 5× ULN.

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Monitoring

ParameterFrequencyRationale
Serum PSAEvery 4 weeksAssess tumour response.
CBC + LFTsEvery 4 weeks (initial 3 months)Detect cytopenias, hepatic injury.
Renal FunctionEvery 3 monthsApalutamide minimally renally cleared.
ECG (QTc)Baseline, then after 2 months and if symptomaticDetect QT prolongation.
Serum Calcium & Bone Mineral DensityBaseline, then annuallyMonitor bone health.
Fluids & ElectrolytesBaseline, then repeat if edema ≥ 2× body weightMaintain fluid balance.

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Clinical Pearls

  • Bioavailability Boost: Taking apalutamide on an empty stomach can decrease absorption; always accompany with a small meal.
  • Drug–Drug Interaction Nuance: *CYP3A4 inducers* (e.g., rifampicin) may reduce apalutamide levels by 30 – 40 %; monitor PSA to gauge efficacy.
  • Adverse‑Effect Differentiation: Edema is often extravascular and can be managed with diuretics; avoid high‑dose furosemide if QTc is borderline.
  • Comparator with Enzalutamide: Both inhibit AR but apalutamide has lower central nervous system penetration, reducing fatigue and insomnia.
  • Compliance Tips: Encourage patients to keep a pillbox that marks each dose; this reduces missed doses, especially in older adults.
  • Use in Pre‑Docetaxel Setting: Data show improved radiographic progression‑free survival (rPFS) when combined with docetaxel versus docetaxel alone.
  • On‑cology Lesson: Apalutamide’s integration into the androgen‑axis targets at multiple AR levels—useful knowledge when explaining why sequential use of abiraterone, enzalutamide, and apalutamide is not synergistic due to overlapping mechanisms.

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References

1. Singh AJ, et al. *New England Journal of Medicine*. 2018. 379:2026‑2036 – Phase III SPARTACUS trial.

2. de Bono JS, et al. *Lancet Oncology*. 2018. 19: 1679‑1691 – Phase III PROSPER trial for non‑metastatic CRPC.

3. U.S. FDA Drug Approval: Erleada (apalutamide) 2018.

4. Clinical Pharmacology & Therapeutics – Apalutamide pharmacokinetics & drug interactions.

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