Quantity over quality.

Or why not have both? In the SPARTAN trial, men with non-metastatic castration-resistant prostate cancer and a PSA doubling time <10 months had a 2 year (!) absolute improvement in metastasis-free survival with the addition of apalutamide to androgen deprivation (ADT). But was the gain worth the additional toxicity? This exploratory analysis of health-related quality of life (QOL) astutely counters: what additional toxicity? At baseline, participants overall had HRQOL similar to the general population. QOL declined over time in both groups, but more so in the placebo group. That’s because decreased quality was mainly associated with, you guessed it, disease progression. TBL: The addition of apalutamide to ADT in men with non-metastatic castration-resistant prostate cancer improves quality of life by significantly reducing disease progression. | Saad, Lancet Oncol 2018