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Clin Cancer Res. 2017 Aug 15;23(16):4592-4601. doi: 10.1158/1078-0432.CCR-16-2245. Epub 2017 Apr 7.

Association of Tissue Abiraterone Levels and SLCO Genotype with Intraprostatic Steroids and Pathologic Response in Men with High-Risk Localized Prostate Cancer.

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Fred Hutchinson Cancer Research Center, Seattle, Washington.
Palo Alto Medical Foundation, Palo Alto, California.
Fred Hutchinson Cancer Research Center, Seattle, Washington.
Lerner Research Institute, Glickman Urological and Kidney Institute, and Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio.
Geriatric Research, Education and Clinical Center, VA Puget Sound Health Care System, Seattle, Washington.
University of Washington, Seattle, Washington.
Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts.
Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Beth Israel Deaconess Medical Center, Boston, Massachusetts.
Memorial Sloan Kettering Cancer Center, New York, New York.


Purpose: Germline variation in solute carrier organic anion (SLCO) genes influences cellular steroid uptake and is associated with prostate cancer outcomes. We hypothesized that, due to its steroidal structure, the CYP17A inhibitor abiraterone may undergo transport by SLCO-encoded transporters and that SLCO gene variation may influence intracellular abiraterone levels and outcomes.Experimental Design: Steroid and abiraterone levels were measured in serum and tissue from 58 men with localized prostate cancer in a clinical trial of LHRH agonist plus abiraterone acetate plus prednisone for 24 weeks prior to prostatectomy. Germline DNA was genotyped for 13 SNPs in six SLCO genes.Results: Abiraterone levels spanned a broad range (serum median 28 ng/mL, 108 nmol/L; tissue median 77 ng/mL, 271 nmol/L) and were correlated (r = 0.355, P = 0.001). Levels correlated positively with steroids upstream of CYP17A (pregnenolone, progesterone), and inversely with steroids downstream of CYP17A (DHEA, AED, testosterone). Serum PSA and tumor volumes were higher in men with undetectable versus detectable tissue abiraterone at prostatectomy (median 0.10 vs. 0.03 ng/dL, P = 0.02; 1.28 vs. 0.44 cc, P = 0.09, respectively). SNPs in SLCO2B1 associated with significant differences in tissue abiraterone (rs1789693, P = 0.0008; rs12422149, P = 0.03) and higher rates of minimal residual disease (tumor volume < 0.5 cc; rs1789693, 67% vs. 27%, P = 0.009; rs1077858, 46% vs. 0%, P = 0.03). LNCaP cells expressing SLCO2B1 showed two- to fourfold higher abiraterone levels compared with vector controls (P < 0.05).Conclusions: Intraprostatic abiraterone levels and genetic variation in SLCO genes are associated with pathologic responses in high-risk localized prostate cancer. Variation in SLCO genes may serve as predictors of response to abiraterone treatment. Clin Cancer Res; 23(16); 4592-601. ©2017 AACR.

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