Abiraterone acetate and prednisone in chemotherapy-naïve prostate cancer patients: rationale, evidence and clinical utility

Therapeutic Advances in Medical Oncology
E David CrawfordCharles J Ryan

Abstract

Abiraterone acetate 1000 mg/day, combined with prednisone 5 mg PO twice daily, is indicated for the treatment of metastatic castration-resistant prostate cancer (mCRPC). Abiraterone acetate is the oral prodrug of abiraterone, a specific CYP17 inhibitor that blocks androgen biosynthesis within the adrenal glands, testes and tumor microenvironment. In a phase III trial of men with asymptomatic or minimally symptomatic, chemotherapy-naïve mCRPC, treatment with oral abiraterone acetate plus prednisone led to a statistically significant improvement in the co-primary endpoints of overall survival and radiographic progression-free survival when compared with placebo plus prednisone. In long-term follow-up of phase III trials, the incidence of corticosteroid-associated adverse events was 25.5% in the abiraterone acetate plus prednisone arm compared with 23.3% in the placebo plus prednisone arm. The need for regular patient monitoring and appropriate management of symptoms during long-term use of prednisone must be placed in context with the improvement in survival seen with abiraterone plus prednisone. Within the multidisciplinary environment that is emerging to meet quality and cost imperatives, abiraterone acetate plus prednisone is ...Continue Reading

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Citations

Jul 30, 2019·Expert Opinion on Drug Safety·Pietro CastellanLuca Cindolo
Aug 23, 2018·Prostate Cancer and Prostatic Diseases·E David CrawfordLaurence Klotz
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Aug 27, 2021·Current Oncology·Mar Sempere-BigorraOmar Cauli

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Clinical Trials Mentioned

NCT01867710
NCT02200614
NCT01715285
NCT01957436
NCT00268476
NCT02446405
NCT02489318
NCT01809691
NCT01314118
NCT01946204

Software Mentioned

PROSPER
LATITUDE
PEACE
SPARTAN
STAMPEDE

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