Taking low-dose abiraterone with food may cut cost of prostate cancer treatment
Patients with castration-resistant prostate cancer (CRPC) may be able to reduce treatment cost by taking low-dose abiraterone acetate with a low-fat breakfast as a study shows noninferiority of the regimen compared with standard dosing on an empty stomach.
Researchers randomized 72 patients (median age, 74 years) with progressive CRPC from the US and Singapore to receive abiraterone acetate at a reduced dose of 250 mg/day with a low-fat breakfast or the standard dose of 1,000 mg/day on an empty stomach. Mean log-change in prostate-specific antigen (PSA) level at 3 months was not significantly different between the low-dose and standard-dose groups (-1.59 vs -1.19). [ASCO GU 2017, abstract 176]
“The median time to PSA progression was approximately 14 months in both arms,” reported Dr Russell Szmulewitz of the University of Chicago, Illinois, US. “Preliminary pharmacokinetic analysis showed no difference in peak serum concentration beyond the first cycle, with lower pharmacokinetic variability in the low-dose arm.”
“Although peak serum concentration of abiraterone acetate can be approximately 17 times higher when taken with a high-fat meal, the drug was administered under fasting conditions in pivotal trials,” Szmulewitz continued. “There were no randomized continuous dosing studies evaluating the effect of prandial state dosing on the drug’s pharmacokinetics and pharmacodynamics.”
“PSA response and progression are not clinically validated surrogates, but our data warrant consideration by prescribers and payers,” he added.