Abiraterone acetate plus prednisone/prednisolone in hormone-sensitive and castration-resistant metastatic prostate cancer

2020 ◽  
pp. 1-9
Author(s):  
Jürgen E Gschwend ◽  
Kurt Miller
Keyword(s):  
Prostate Cancer ◽  
Metastatic Prostate Cancer ◽  
Abiraterone Acetate ◽  
Castration Resistant ◽  
Hormone Sensitive

Efficacy of abiraterone acetate in castration‐resistant metastatic prostate cancer: A real‐world data analysis

2020 ◽  
Author(s):  
Abdilkerim Oyman ◽  
Mustafa Başak ◽  
Melike Özçelik ◽  
Deniz Tataroğlu Özyükseler ◽  
Selver Işık ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Data Analysis ◽  
Real World ◽  
Metastatic Prostate Cancer ◽  
Abiraterone Acetate ◽  
Real World Data ◽  
World Data ◽  
Castration Resistant

scholarly journals Monitoring Patients with Metastatic Hormone-Sensitive and Metastatic Castration-Resistant Prostate Cancer: A Multidisciplinary Consensus Document

Cancers ◽  
2019 ◽  
Vol 11 (12) ◽  
pp. 1908
Author(s):  
Alberto Lapini ◽  
Orazio Caffo ◽  
Giovanni Pappagallo ◽  
Roberto Iacovelli ◽  
Rolando Maria D’Angelillo ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Metastatic Prostate Cancer ◽  
Hormonal Treatment ◽  
Castration Resistant Prostate Cancer ◽  
Disease Evolution ◽  
Consensus Document ◽  
Castration Resistant ◽  
The Metabolic Syndrome ◽  
Hormone Sensitive ◽  
Monitoring Protocols

Background: The availability of a number of agents that are efficacious in patients with metastatic prostate cancer (mPC) has led to them being used sequentially, and this has prolonged patient survival. However, in order to maximize their efficacy, clinicians need to be able to obtain a reliable picture of disease evolution by means of monitoring procedures. Methods: As the intensive monitoring protocols used in pivotal trials cannot be adopted in everyday clinical practice and there is no agreement among the available guidelines, a multidisciplinary panel of Italian experts met to develop recommendations for monitoring mPC patients using a modified Delphi method. Results: The consensus project considered methods of clinically, radiographically, and biochemically monitoring patients with metastatic hormone-sensitive and metastatic castration-resistant prostate cancer undergoing chemotherapy and/or hormonal treatment. The panelists also considered the methods and timing of monitoring castration levels, bone health, and the metabolic syndrome during androgen deprivation therapy. Conclusions: The recommendations, which were drawn up by experts following a formal and validated consensus procedure, will help clinicians face the everyday challenges of monitoring metastatic prostate cancer patients.

scholarly journals Abiraterone acetate in combination with prednisone in the treatment of metastatic hormone-sensitive prostate cancer: clinical evidence and experience

2019 ◽  
Vol 11 ◽  
pp. 175628721882080 ◽  
Author(s):  
Karin Purshouse ◽  
Andrew S. Protheroe
Keyword(s):  
Prostate Cancer ◽  
Clinical Evidence ◽  
Abiraterone Acetate ◽  
Effective Alternative ◽  
Comparable Efficacy ◽  
Major Barrier ◽  
Healthcare Settings ◽  
Castration Resistant ◽  
Metastatic Setting ◽  
Hormone Sensitive

More than a million men worldwide are diagnosed with prostate cancer every year. After androgen deprivation therapy (ADT), chemotherapy has been the only subsequent intervention to improve survival in the metastatic setting but has limitations for patients who may not tolerate its toxicity profile or are not candidates on the basis of comorbidities. Novel anti-androgens such as abiraterone acetate have shown promise for such patients. This review draws on clinical evidence and experience to identify abiraterone as a well-tolerated, effective alternative to docetaxel. In the castration-resistant setting, studies demonstrated a survival benefit over placebo, prompting further trials in the hormone-naïve population. More recently the STAMPEDE and LATITUDE studies suggest abiraterone has comparable survival outcomes to docetaxel in the castration-sensitive setting, with evidence in favour of its quality of life profile. Available comparisons with docetaxel are limited, but those available suggest they have comparable efficacy. However, the significant cost compared with docetaxel is a major barrier in resource-rationed healthcare settings. Overall, abiraterone is an effective alternative to chemotherapy for men with castration-sensitive prostate cancer, but this should be balanced with the significantly greater cost.

Evidence for circulating tumor cell (CTC) alkaline phosphatase (AP) expression in men with bone-metastatic castration-resistant prostate cancer (CRPC) during abiraterone acetate treatment.

2014 ◽  
Vol 32 (4_suppl) ◽  
pp. 178-178
Author(s):  
Andrew J. Armstrong ◽  
Rhonda Lynn Bitting ◽  
Gabor Kemeny ◽  
Daniel J. George
Keyword(s):  
Prostate Cancer ◽  
Alkaline Phosphatase ◽  
Tumor Cells ◽  
Metastatic Prostate Cancer ◽  
Elevated Serum ◽  
Abiraterone Acetate ◽  
High Serum ◽  
Castration Resistant Prostate Cancer ◽  
Castration Resistant ◽  
Epithelial Plasticity

178 Background: Serum alkaline phosphatase (AP) changes in men with metastatic prostate cancer have been described since the Nobel Prize winning discovery of the hormonal dependence of PC. High serum AP is independently associated with mortality in men with castration-resistant prostate cancer (CRPC) and reductions in AP with treatment are favorably prognostic. Transient rises in AP may occur during treatment initiation and reflect bone remodeling/healing. The source of serum AP in men with metastatic prostate cancer, however, remains unclear. We hypothesize that cancer cell osteomimicry and epithelial plasticity may contribute to serum AP elevations in these men. Methods: We examined the expression of AP in the circulating tumor cells (CTCs) of men with metastice CRPC on abiraterone acetate who had elevated serum AP to determine if one possible source of serum AP may be tumor-derived rather than host/bone derived. CTCs were isolated using the CellSearch method and EpCAM ferromagnetic capture, and only CD45 negative cells were considered CTCs. AP was evaluated using immunofluorescence and real time positive and negative controls. Liver function was evaluated to ensure lack of confounding with liver-derived AP. Results: We identified AP to be commonly expressed in the CTCs of men with CRPC who had high serum AP, with no expression in patient leukocytes. One patient had a transient rise in serum AP with no change in other liver enzymes during a dramatic response to abiraterone acetate while his prostate-specific antigen and CTC declined. AP expression was evident and common in his CTCs during this serum AP flare. A second patient was found to have common CTC AP expression in both CK+ and CK- CTCs. This patient had evidence of AR amplification, PTEN loss, and TMPRSS2-ERG fusion in his CK- and CK+ CTCs, accompanied by a high number of OB-cadherin + CTCs, indicating likely osteomimicry and plasticity of these clonal epithelial tumor cells. Conclusions: We provide clinical evidence that PC CTCs express AP, supporting the hypothesis that AP expression is associated with osteomimicry as part of the biology of epithelial plasticity in prostate cancer. These findings support the existence of multiple CTC phenotypes, the clinical significance of which is unknown.

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