Agarwal N, McQuarrie K, Bjartell A, et al. - Given that a significant improvement in the primary endpoints of overall survival and radiographic progression-free survival was brought about by the addition of apalutamide to androgen deprivation therapy (ADT) in patients with metastatic castration-sensitive prostate cancer in the phase 3 TITAN study, researchers evaluated health-related quality of life (HRQOL) in TITAN, including pain and fatigue, via this randomised, placebo-controlled, double-blind, phase 3 study. The eligible patients were randomly allocated (1:1) to treatment with oral apalutamide (four 60 mg tablets, once daily) or matching placebo. Prior localised disease therapy or prior docetaxel for metastatic castration-sensitive prostate cancer were permitted. Findings revealed the good tolerability as well as the efficacy of apalutamide with ADT in the treatment of men with metastatic castration-sensitive prostate cancer. Significantly improved survival outcomes were achieved with the combination therapy vs ADT alone, with maintained HRQOL despite additive androgen blockade.