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Eur Urol. 2011 Aug;60(2):270-8. doi: 10.1016/j.eururo.2011.04.032. Epub 2011 Apr 29.

The role of abiraterone acetate in the management of prostate cancer: a critical analysis of the literature.

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  • 1Veterans Affairs Medical Centre and the Baylor College of Medicine, Houston, TX, USA.

Abstract

CONTEXT:

The development of agents targeting androgen signalling holds promise for men with castration-resistant prostate cancer (CRPC).

OBJECTIVE:

The emerging role of abiraterone acetate (AA), a novel, orally administered androgen synthesis inhibitor, is critically analysed.

EVIDENCE ACQUISITION:

Data were acquired from critically important original research published in peer-reviewed literature or presented at conferences conducted by the American Society of Clinical Oncology and the European Society of Medical Oncology.

EVIDENCE SYNTHESIS:

The major findings are addressed in an evidence-based, objective, and balanced fashion.

CONCLUSIONS:

AA specifically inhibits CYP17 and substantially reduces serum androgen levels without inducing significant adrenal insufficiency. A phase 3 trial reported a significant extension of survival in metastatic CRPC with AA plus prednisone compared to prednisone alone following docetaxel. The primary toxicity of mineralocorticoid excess is manageable. The addition of low-dose corticosteroids to AA may be necessary for controlling symptoms of mineralocorticoid excess.

Copyright © 2011 European Association of Urology. Published by Elsevier B.V. All rights reserved.

PMID:
21550166
[PubMed - indexed for MEDLINE]
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