Apalutamide Plus ADT - Safety and Tolerability Findings

Grade 3/4 adverse events were similar between arms, roughly 39.1% with apalutamide plus ADT versus 30–31% with ADT alone. The modest excess in the apalutamide arm was largely attributable to rash, a well-established side effect managed with standard approaches — antihistamines and topical or oral steroids — already used for apalutamide in the metastatic setting. Dr. Kalantri frames the safety data as reassuring: adding apalutamide to perioperative ADT doesn't introduce substantial new toxicity concerns, supporting its use once efficacy benefits are weighed against this manageable profile.