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ERLEADA - Use of ERLEADA in Patients with Hepatic Impairment

Last Updated: 03/24/2026

SUMMARY  

  • The recommended dosage of ERLEADA for patients with severe hepatic impairment (Child-Pugh Class C) is 120 mg (two 60 mg tablets) administered orally once daily.1 Please refer to local labeling for additional considerations and data.
  • No dosage modification is recommended for patients with mild (Child-Pugh Class A) or moderate (Child-Pugh Class B) hepatic impairment.1
  • In the phase 3 SPARTAN Study and TITAN Study, eligible patients were required to have adequate hepatic function (defined as serum aspartate transaminase [AST] and serum alanine transaminase [ALT] ≤2.5x upper limit of normal [ULN], and total serum bilirubin ≤1.5x ULN).2-5

clinical DATA

Phase 3 SPARTAN Study

In the phase 3 SPARTAN study, which evaluated the efficacy and safety of ERLEADA compared to placebo in patients with high-risk non-metastatic castration-resistant prostate cancer (nmCRPC; defined as prostate-specific antigen [PSA] doubling time [PSADT]
≤10 months) on continuous androgen deprivation therapy (N=1207), eligible patients were required to have adequate hepatic function, which was defined by the following criteria: serum AST and serum ALT ≤2.5x ULN, and total serum bilirubin ≤1.5x ULN.2,3

Phase 3 TITAN Study

In the phase 3 TITAN study, which evaluated the efficacy and safety of ERLEADA compared to placebo in patients with metastatic castration-sensitive prostate cancer (mCSPC) on continuous ADT (N=1052), eligible patients were required to have adequate hepatic function, which was defined by the following criteria: serum AST and serum ALT ≤2.5x ULN, and total serum bilirubin ≤1.5x ULN.4,5

Literature Search

A literature search of MEDLINE®, Embase®, BIOSIS Previews®, and Derwent Drug File (and/or other resources, including internal/external databases) was conducted on 22 August 2025.

 

References

1 Data on File. Apalutamide. Company Core Data Sheet. Janssen Research & Development, LLC. EDMS-ERI-146013831; 2026.  
2 Smith MR, Saad F, Chowdhury S, et al. Apalutamide treatment and metastasis-free survival in prostate cancer. N Engl J Med. 2018;378(15):1408-1418.  
3 Smith MR, Saad F, Chowdhury S, et al. Protocol for: Apalutamide treatment and metastasis-free survival in prostate cancer. N Engl J Med. 2018;378(15):1408-1418.  
4 Chi KN, Agarwal N, Bjartell A, et al. Protocol for: Apalutamide for metastatic, castration-sensitive prostate cancer. N Engl J Med. 2019;381(1):13-24.  
5 Chi KN, Agarwal N, Bjartell A, et al. Apalutamide for metastatic, castration-sensitive prostate cancer. N Engl J Med. 2019;381(1):13-24.