Biochemical and objective response to abiraterone acetate withdrawal: incidence and clinical relevance of a new scenario for castration-resistant prostate cancer

Urology. 2013 Nov;82(5):1090-3. doi: 10.1016/j.urology.2013.07.029. Epub 2013 Aug 31.

Abstract

Objective: To describe the incidence and clinical relevance of biochemical and objective responses to abiraterone acetate (AA) withdrawal (AAWD) in patients with castration-resistant prostate cancer (CRPC).

Materials and methods: Twenty-six patients with progressive CRPC treated with first-line docetaxel-based chemotherapy were administered with AA at the standard dose of 1000 mg/day in combination with prednisone until progression. The patients were regularly followed up during treatment and after AAWD.

Results: Nineteen of the 26 patients discontinued AA because of progression. Three of the patients undergoing AAWD experienced a biochemical response, which was accompanied by a metabolic and radiological response as revealed by choline positron emission tomography in 2 cases.

Conclusion: Regardless of the underlying molecular bases, AAWD response does not occur rarely. It is sometimes long-lasting and accompanied by a metabolic and radiographic improvement. AAWD response should be taken into account when further therapeutic strategies are planned in patients with CRPC with progressive disease during abiraterone therapy.

MeSH terms

  • Abiraterone Acetate
  • Aged
  • Androgen Antagonists / therapeutic use
  • Androstadienes / therapeutic use*
  • Disease Progression
  • Docetaxel
  • Follow-Up Studies
  • Humans
  • Male
  • Prednisone / therapeutic use
  • Prostate-Specific Antigen / metabolism
  • Prostatic Neoplasms, Castration-Resistant / drug therapy*
  • Taxoids / administration & dosage
  • Taxoids / therapeutic use
  • Treatment Outcome

Substances

  • Androgen Antagonists
  • Androstadienes
  • Taxoids
  • Docetaxel
  • Prostate-Specific Antigen
  • Abiraterone Acetate
  • Prednisone