Abiraterone in the management of castration-resistant prostate cancer prior to chemotherapy

Research output: Contribution to journalReview article

17 Scopus citations

Abstract

The treatment armamentarium for metastatic castration-resistant prostate cancer (mCRPC) has increased significantly over the past several years. Approved drugs associated with improved survival include androgen pathway-targeted agents (abiraterone acetate and enzalutamide), chemotherapeutics (docetaxel and cabazitaxel), an autologous vaccine (sipuleucel-T) and a radiopharmaceutical (radium-223). Abiraterone acetate, a prodrug of abiraterone, inhibits the CYP17A enzyme, a critical enzyme in androgen biosynthesis. Abiraterone has regulatory approval in mCRPC in both chemotherapy-naïve patients and in the post-docetaxel setting based on results from two randomized phase III studies. In the COU-AA-302 trial, abiraterone demonstrated significant improvement in the coprimary endpoints of radiographic progression-free survival and overall survival, as well as in a number of secondary endpoints including time until initiation of chemotherapy, time until opiate use for cancer-related pain, prostate-specific antigen progression-free survival and decline in performance status. Abiraterone is well-tolerated, although adverse events associated with this agent include abnormalities in liver function testing and mineralocorticoid-associated adverse events. This review evaluates the use of abiraterone in mCRPC prior to the use of chemotherapy.

Original languageEnglish (US)
Pages (from-to)194-202
Number of pages9
JournalTherapeutic Advances in Urology
Volume7
Issue number4
DOIs
StatePublished - Aug 2015

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Keywords

  • abiraterone
  • castration-resistant
  • chemotherapy-naïve
  • prostate cancer

ASJC Scopus subject areas

  • Urology

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