Abiraterone Acetate for the Treatment of Castrate-Refractory Prostate Cancer

Abstract

Patients with de novo metastatic prostate cancer are primarily treated with androgen deprivation with very high (>95%) response rates, but all patients eventually develop castrate-refractory prostate cancer, which has a poor prognosis. Accumulating evidence suggests that continued androgen receptor signaling remains critical for survival and growth, with adrenal and intratumoral sources of androgens contributing to disease activation. Abiraterone acetate is a novel androgen biosynthesis inhibitor that has been shown to improve survival for patients with metastatic castrate-refractory prostate cancer who have progressed on docetaxel chemotherapy. It is a well-tolerated orally administered drug with a low incidence of serious side effects, taken with prednisone to reduce the secondary effects of mineralocorticoid excess. In the chemo-naive population, a recent trial has also shown improved outcomes, and ongoing studies are investigating its role even earlier in the disease course and in combination with other drugs.