Apalutamide-Induced Drug Reaction With Eosinophilia and Systemic Symptoms (DRESS) Syndrome in a Patient With Metastatic Prostate Cancer: A Case Report
- 1Department of Oncology, Ninewells Hospital, Dundee, GBR
Abstract
Metastatic prostate cancer is a leading cause of cancer-related morbidity and mortality. Androgen deprivation therapy (ADT) remains the foundation of systemic treatment, with novel androgen receptor inhibitors such as apalutamide increasingly used in patients with metastatic hormone-sensitive prostate cancer (mHSPC). Apalutamide is generally well tolerated. Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is not recognized as an established side effect of apalutamide.
We report the case of a man in his seventies who was initiated on apalutamide for mHSPC. Ten days after initiation, he developed a widespread maculopapular rash accompanied by biochemical abnormalities. Clinical assessment suggested a diagnosis of DRESS syndrome, most consistent with the criteria of Bocquet et al. The patient was managed with immediate discontinuation of apalutamide and initiation of high-dose systemic corticosteroids. He improved clinically and biochemically and subsequently transitioned to enzalutamide.
This case highlights the importance of recognizing rare but potentially life-threatening adverse reactions associated with apalutamide.
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BibTeX
@article{kabir2026apalutamideinduced,
title = {{Apalutamide-Induced Drug Reaction With Eosinophilia and Systemic Symptoms (DRESS) Syndrome in a Patient With Metastatic Prostate Cancer: A Case Report}},
author = {Shawly Kabir and Lynne Cormode},
journal = {Cureus},
year = {2026},
month = oct,
doi = {10.7759/cureus.117816},
url = {https://europepmc.org/article/PMC/PMC13730540},
note = {CC BY},
}
RIS
TY - JOUR
TI - Apalutamide-Induced Drug Reaction With Eosinophilia and Systemic Symptoms (DRESS) Syndrome in a Patient With Metastatic Prostate Cancer: A Case Report
AU - Shawly Kabir
AU - Lynne Cormode
PY - 2026
DA - 2026/10/12
JO - Cureus
DO - 10.7759/cureus.117816
UR - https://europepmc.org/article/PMC/PMC13730540
AB - Metastatic prostate cancer is a leading cause of cancer-related morbidity and mortality. Androgen deprivation therapy (ADT) remains the foundation of systemic treatment, with novel androgen receptor inhibitors such as apalutamide increasingly used in patients with metastatic hormone-sensitive prostate cancer (mHSPC). Apalutamide is generally well tolerated. Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is not recognized as an established side effect of apalutamide. We report the case of a man in his seventies who was initiated on apalutamide for mHSPC. Ten days after initiation, he developed a widespread maculopapular rash accompanied by biochemical abnormalities. Clinical assessment suggested a diagnosis of DRESS syndrome, most consistent with the criteria of Bocquet et al. The patient was managed with immediate discontinuation of apalutamide and initiation of high-dose systemic corticosteroids. He improved clinically and biochemically and subsequently transitioned to enzalutamide. This case highlights the importance of recognizing rare but potentially life-threatening adverse reactions associated with apalutamide.
SN - 2168-8184
ER -