Real-world analysis of apalutamide-associated skin rash in Chinese patients with prostate cancer

This study aimed to explore the clinical characteristics of apalutamide-associated skin rash and management of skin rash in real-world Chinese patients with prostate cancer.

We investigated 138 patients with prostate cancer who received apalutamide in the Second Hospital of Tianjin Medical University from January 2022 to March 2023. The primary end points were the incidence of skin rash and the time to skin rash. The second end points were the grade of skin rash, the time to remission, the rate of recurrence of skin rash, clinical risk factors and management of skin rash.

One hundred patients were analyzed. Patients were a median of 73 years old (IQR 68–77.75). Thirty-two patients (32%) developed apalutamide‑associated skin rash. The median time to incidence and remission of skin rash were 57.5 and 11.5 days, respectively. Of 32 skin rash, 27 patients had apalutamide therapy maintained after rash remission. There were seven patients having recurrence of skin rash. By multivariable logistic regression analysis, we revealed that hypertension history (OR 3.22, 95% CI 1.09–9.53, p = 0.035), bad life-styles (OR 3.29, 95% CI 1.11–9.8, p = 0.032), ECOG ≥ 1 (OR 3.92, 95% CI 1.33–11.55, p = 0.013), and high tumor burden (OR 3.13, 95% CI 1.07–9.14, p = 0.037) were independently associated with higher incidence of skin rash.

Nearly one-third of Chinese patients experienced skin rash after taking apalutamide in our study. The poor health patients might have a higher incidence of apalutamide-associated skin rash.