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Survival outcome and prognostic factors in patients with chemotherapy-naive metastatic castration-resistant prostate cancer treated with abiraterone acetate – real-world experience in Vietnam

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Do T. A. , Nguyen T. H. T. , Nguyen H. X. , Nguyen L. D. , Nguyen C. V.

nr 2

262-269

Introduction and aim. In real life, metastatic castration-resistant prostate cancer patients (mCRPC) had more complex clinical presentation than patients in the COU-AA-302 trial. This study primarily aimed to describe the overall survival of chemotherapy-naive mCRPC treated with abiraterone acetate plus prednisone (AAP). Other relevant outcomes and baseline characteristics of these patients were also evaluated. Material and methods. This retrospective, observational study collected data from chemotherapy-naive mCRPC patients treated with AAP in Vietnam. Kaplan-Meier curves were used to estimate time to treatment failure (TTF), and overall survival (OS). The impact of baseline characteristics on OS was explored using univariate and multivariate Cox proportional hazard models. Results. Data from 65 eligible patients were analyzed. The rate of PSA response was 73.8%, median PSA PFS was 10.5 months (95% CI: 7.4–13.6), median TTF was 15 months (95% CI: 11.1–18.9), and median OS was 24.9 months (95% CI: 18.9–30.9). Shorter OS was significantly associated with a higher Gleason score (≥8), shorter time from ADT start to mCRPC (<12 months), visceral metastases, and <50% PSA decline (p<0.05). Conclusion. Abiraterone acetate plus prednisone is well tolerated and effective for chemotherapy-naive mCRPC patients in clinical practice. Moreover, Gleason score, visceral metastasis, time from ADT start to mCRPC, and PSA response are the independent indicators for predicting the OS of mCRPC patients in both univariate and multivariate analyses.

Abiraterone acetate – 10 clinically relevant facts

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Żołnierek J.

OncoReview

2021

tom 11

nr 3

80-84

Prostate cancer is one of the most frequently diagnosed cancers in men. Number of newly diagnosed cases is increasing due to several factors and the most important ones seem to be: population ageing and more sensitive diagnostic procedures. Secondary – the higher efficacy of treatment with its influence on improving patients’ overall survival and the specific mechanism of action of drugs used in systemic therapy lead to growing population of men suffering from prostate cancer in general and, specifically – patients with castration resistance. It is hormone therapy to play the key role in systemic treatment of prostate cancer with increasing significance of novel drugs focused on inhibition of molecular signal transduction mediated by androgen receptor. Abiraterone acetate is the representative of this therapeutic class. The paper describes the most clinically relevant data regarding the drug.

Cardiovascular complications during the treatment of castration-resistant prostate cancer with the use of modern antiandrogens: abiraterone acetate and enzalutamide

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Grabysa R. , Chmielewska A.

OncoReview

2021

tom 11

nr 3

61-67

Modern antiandrogens: abiraterone acetate (inhibitor of CYP17 cytochrome) and enzalutamide (irreversible inhibitor of androgen receptor) are the drugs that are increasingly often administered in treatment of castration-resistant prostate cancer. Despite their clinical efficacy, especially in terms of prolonged survival and improved quality of life of patients, they pose of problem for a practicing oncologist such as possible cardiovascular complications (particularly arterial hypertension), which may lead to the cessation of this form of therapy. This article provides a brief overview of the mechanisms responsible for the above complications, including practical recommendations in the event such complications arise. A simple scheme of action for control of cardiovascular risk factors has been presented, which can improve the prognosis in this population of patients.