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

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.

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

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).

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.

Cancer treatment and research communications. 2018 Oct 16 [Epub ahead of print]

Grégoire Marret, Ludovic Doucet, Christophe Hennequin, Karim Fizazi, Stéphane Culine

Department of Cancer Medicine, Hôpital Saint Louis, Paris, France. Electronic address: ., Department of Cancer Medicine, Hôpital Saint Louis, Paris, France. Electronic address: ., Department of Radiotherapy, Hôpital Saint Louis, Paris, France. Electronic address: ., Department of Cancer Medicine, Gustave Roussy, University of Paris Saclay, Villejuif, France. Electronic address: ., Department of Cancer Medicine, Hôpital Saint Louis, Paris, France. Electronic address: .

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