The development of abiraterone acetate for castration-resistant prostate cancer

Abiraterone acetate is a novel CYP17A1 inhibitor demonstrated to prolong survival in castration-resistant prostate cancer (CRPC). This review explores key stages in the almost 20-year history of abiraterone acetate׳s development, starting with a program aiming to develop inhibitors of androgen synthesis at the Institute of Cancer Research, London.

Clinical development was initially slow owing to insufficient data supporting targeting of androgen synthesis as a therapeutic approach in CRPC and safety concerns of adrenocortical insufficiency from suppression of cortisol. Regulatory authorities approved abiraterone acetate in 2011 after a survival benefit was demonstrated when given in combination with prednisone as compared with prednisone alone in docetaxel-treated men. Licensing approval extended to include chemotherapy-naive patients with CRPC in 2012 following a significant increase in radiographic progression-free survival. Ongoing research focuses on identifying predictive biomarkers and understanding mechanisms of resistance to improve its administration.

Urol Oncol. 2015 Jun;33(6):289-294. doi: 10.1016/j.urolonc.2015.03.021.

Grist E1, Attard G2.

1The Institute of Cancer Research, London, UK; Royal Marsden NHS Foundation Trust, London, UK.
2The Institute of Cancer Research, London, UK; Royal Marsden NHS Foundation Trust, London, UK.

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