Efficacy of abiraterone acetate in post-docetaxel castration-resistant prostate cancer

Abstract

Evaluation of: Reid AH, Attard G, Danila DC et al. Significant and sustained antitumor activity in post-docetaxel, castration-resistant prostate cancer with the CYP17 inhibitor abiraterone acetate. J. Clin. Oncol. 28(9), 1489–1495 (2010).

Inhibition of cytochrome P17 (CYP17), which is involved in androgen synthesis, is a promising therapeutic strategy for castration-resistant prostate cancer (CRPC). The first multicenter, Phase II study of a CYP17 inhibitor, the small molecule abiraterone acetate, has been conducted on 47 patients that received prior docetaxel chemotherapy for prostate cancer. With 1000 mg once daily, declines of more than 50% in prostate-specific antigen and circulating tumor cell counts were seen in 51 and 63% of patients, respectively. Overall, the drug was well tolerated and had a significant antitumor activity with symptomatic improvements. Reid and colleagues’ study highlights abiraterone as a key molecule in CRPC treatment and gives further evidence of the involvement of the androgen receptor signaling axis in the disease. A randomized Phase III trial is ongoing to define the prognostic impact of this drug among the very limited arsenal of drugs currently available for CRPC. In the meantime, other CYP17 inhibitors are expected to show a favorable safety and efficacy profile, as are other novel powerful agents and combinatorial therapeutic strategies.

Keywords::

• abiraterone acetate
• castration-resistant prostate cancer
• cytochrome P17
• docetaxel
• MDV3100

Acknowledgements

The authors truly regret that they could not cite the seminal work of many colleagues owing to space constraints.

Financial & competing interests disclosure

Paraskevi Vogiatzi acknowledges her postdoctoral fellowship at Thomas Jefferson University, Philadelphia, PA, USA. This work was partially funded by NIH CA138510, CA140024, COBRE 5P20RR020180, and WV-INBRE 5P20RR016477 (to Pier Paolo Claudio). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.