# Low-Dose Apalutamide in Nonmetastatic Castration-Resistant Prostate Cancer: A Case Report

## TL;DR

This case report explores the use of a low dose of apalutamide in an elderly patient with prostate cancer, showing a three-year survival without metastasis.

## Contribution

The novelty lies in suggesting low-dose apalutamide as a potential treatment option for elderly patients with nonmetastatic prostate cancer.

## Key findings

- A patient survived three years without metastasis on 25% of the recommended apalutamide dose.
- Treatment discontinuation during lockdowns did not lead to disease progression.
- The case suggests low-dose apalutamide may be effective in elderly patients.

## Abstract

The effect of low-dose apalutamide in nonmetastatic castration-resistant prostate cancer is unknown. We report the observation of therapy being administered at 25% of the recommended dose in an 80-year-old patient. Despite treatment discontinuation during COVID lockdowns, he survived three years without evidence of metastasis. This case gently invites us to reflect on the possibility of low-dose apalutamide in the elderly.