Abiraterone in metastatic castration-resistant prostate cancer: Efficacy and safety in unselected patients

Cancer Treat Res Commun. 2018;17:37-42. doi: 10.1016/j.ctarc.2018.10.001. Epub 2018 Oct 16.

Abstract

Background: Abiraterone acetate (AA), an androgen biosynthesis inhibitor, is now a standard of care for men with metastatic, castration-sensitive and castration-resistant prostate cancer (mCRPC). Data exploring real-world toxicity and outcomes are scarce.

Methods: Retrospective study on unselected patients with mCRPC on AA plus steroids.

Results: 93 patients were included in the study. Median duration of treatment by AA was 7.5 months (95% CI 5.7-12) among the 58 patients pretreated with chemotherapy, versus 12.7 months ( 95% CI 8.2-35.9) among the 33 chemo-naive patients. Median survivals would reach 13.4 months (95% CI 10.2-19.1) and 36.4 months (95% CI 24.7-41.5) respectively. Rates of hypokalemia, peripheral edema, hypertension, cardiac failure, and overall survival assessments in patients with and without prior chemotherapy were similar to that previously reported in phase 3 randomized trials. The median survival time without adverse event of special interest was 7.5 months for hypokalemia and hypertension, and 5.3 months for liver-function test abnormalities (it was not reached for cardiac disorders).

Conclusion: Our findings provide further evidence for the survival benefits of AA with a low frequency of additional adverse events among unselected patients. In patients who have not developed hypokalemia or a transaminase increase within 7.5 and 5.3 months respectively, a lighter systematic monitoring may be considered.

Keywords: Abiraterone acetate; Adverse events; Prostate cancer; Real-world practice; Survival.

Publication types

  • Comparative Study
  • Multicenter Study

MeSH terms

  • Abiraterone Acetate / therapeutic use*
  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents / therapeutic use*
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Missouri / epidemiology
  • Prostatic Neoplasms, Castration-Resistant / drug therapy*
  • Prostatic Neoplasms, Castration-Resistant / mortality
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Antineoplastic Agents
  • Abiraterone Acetate