Experience of a Brazilian oncological center using abiraterone acetate in metastatic castration-resistant prostate cancer patients.

Abstract

364 Background: Abiraterone acetate (AA), a selective inhibitor of androgen biosynthesis, improves overall survival (OS) in metastatic castration-resistant prostate cancer (mCRPC) patients. In Brazil, despite this medication has been approved by health regulatory agency since 2013, due to the high cost, few public services release to their patients. It's interesting to note that this drug configures the eighth most judicial request medication in the country, as the way brazilian constitution ensures equal treatment for all patients. Methods: We performed a unicenter retrospective cohort study of 45 patients with mCRPC, receiving AA after chemotherapy with docetaxel, in the period from 2014 to 2016. The primary end point was OS. The secondary end points included the epidemiological profile, assessing the type of access to medication (judicial request, health insurance and patient's resource) and PSA response rate. Results: The median OS was 15 months. The mean duration use of AA was 10.87 months (± 6.8). Most patients (75.6%) have filed a lawsuit to get the medication and the average time between the request and the application of AA was bigger in this judicial request group (2.7 vs 1.4 months). Biochemical response was evidenced in 39% of patients. Conclusions: Our unicenter data on post-Docetaxel use of AA improved overall survival in a select group of mCRPC patients, and it is in line with the COU-AA-301 trial. Cost effectiveness evaluations combining with a patient`s protocol should be performed in order to incorporate this medication into the brazilian public health system. Characteristics of the patients. [Table: see text]