(UroToday.com) The TITAN phase III clinical trial evaluated apalutamide or placebo added to ADT in patients with men with metastatic castration sensitive prostate cancer (mCSPC). Patients with high- and low-volume disease, prior docetaxel, prior treatment for localized disease, and prior ADT (≤ 6 months) were eligible for the trial. At the first interim analysis, with 22.7 months median follow-up, apalutamide significantly improved dual primary end points of overall survival (HR 0.67, 95% CI 0.51-0.89) and radiographic progression-free survival (HR 0.48, 95% CI 0.39-0.60) compared with placebo.1 At the time of the first data reporting and publication, overall survival analysis was first planned interim while radiographic progression-free survival was final. TITAN was unblinded, allowing patients without progression who were still receiving placebo to cross over to receive apalutamide. At the 2021 American Society of Clinical Oncology Genitourinary Cancers Symposium (ASCO GU), Dr. Kim Chi and colleagues presented results of the final analysis of efficacy and safety results from TITAN.