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GU Cancers 2026 | SAVE: apalutamide versus ADT with salvage radiotherapy in prostate cancer

Piet Dirix, MD, PhD, Iridium Network, Antwerp, Belgium, discusses findings from the SAVE trial (NCT03899077), which evaluated apalutamide as an alternative to androgen deprivation therapy (ADT) combined with salvage radiotherapy for biochemical recurrence after radical prostatectomy. Results indicated that apalutamide monotherapy significantly spared sexual functioning and other quality of life domains compared to standard androgen deprivation therapy, while maintaining similar prostate-specific antigen response rates. This interview took place at the 2026 ASCO GU Cancers Symposium in San Francisco, CA.

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Transcript

So we randomized 202 patients referred for salvage radiotherapy because of a rising PSA between either radiotherapy with six months of conventional ADT versus six months of apalutamide monotherapy. We looked at PROMs, so we collected FACT-B, EPIC-26 and EORTC PR25 and C30 questionnaires at 3, 6 and 9 months after treatment initiation. And we found that apalutamide monotherapy significantly spared erectile function, so sexual function, in those patients with also general health-related quality of life...

So we randomized 202 patients referred for salvage radiotherapy because of a rising PSA between either radiotherapy with six months of conventional ADT versus six months of apalutamide monotherapy. We looked at PROMs, so we collected FACT-B, EPIC-26 and EORTC PR25 and C30 questionnaires at 3, 6 and 9 months after treatment initiation. And we found that apalutamide monotherapy significantly spared erectile function, so sexual function, in those patients with also general health-related quality of life. And it did so without hampering PSA responses. So the oncological outcome was identical.

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