Early abiraterone acetate treatment improves outcomes in CRPC patients
In chemotherapy-naïve castrate-resistant prostate cancer (CRPC) patients, first- and second-line administration of abiraterone acetate (AA) treatment leads to favourable outcomes, a recent Japan study suggests.
Researchers retrospectively analysed the records of 69 CRPC patients who received AA treatment and classified them into two: the early group, who received AA as first- or second-line treatment (n=24), and the deferred group, who received AA as a third-line or later treatment (n=45).
In unadjusted analyses, only the timing of AA treatment was significantly associated with progression-free survival (PFS), such that those in the early group had better outcomes than those in the deferred group (hazard ratio [HR], 3.29; 95 percent CI, 1.66–6.51; p<0.001).
Adjusting for potential confounders did not attenuate the relationship. Although to a slightly lesser degree, early AA treatment remained significantly correlated with better PFS outcomes (HR, 2.99; 1.35–6.64; p<0.01).
Within the early group, there were no significant differences in outcomes between those who received AA as first- or second-line treatment. That is, patients treated first- or second-line treatment were statistically comparable in terms of prostate-specific antigen response, overall survival and PFS. All participants who received AA as second-line treatment were given flutamide as first-line therapy.
Five patients reported grade 3 adverse events, three of whom had hepatic function. Hypokalaemia and thrombocytopaenia were reported in one patient each. Other adverse events reported were either grade 1 or 2, the most common of which was an increase in alanine aminotransferase or aspartate aminotransferase levels.