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Clinical Research

Reversal of PSA progression on abiraterone acetate through the administration with food in men with metastatic castration-resistant prostate cancer

Prostate Cancer and Prostatic Diseases volume 18, pages 161–166 (2015)Cite this article

Subjects

Abstract

Background:

Owing to efficacy and tolerability, abiraterone acetate (AA) is a leading treatment for men with metastatic castration-resistant prostate cancer. Increased serum concentrations of AA, such as by taking AA with food, may lead to the inhibition of additional enzymes in the androgen synthesis pathway implicated in castration-resistant prostate cancer progression.

Methods:

Medical records of men with metastatic castration-resistant prostate cancer (mCRPC) who received AA between 1 April 2011 and 31 December 2013 were retrospectively reviewed. The primary outcome was the percent of men with a rising PSA on AA who experienced any PSA decline within 3 months after changing the administration of AA from without food to with food. Secondary outcomes were median time on AA therapy in men who received AA therapy without food versus those that switched administration from without food to with food at PSA progression, and the percent of men who experienced any decline in serum testosterone concentration, and the rate of adverse events observed while taking AA with food.

Results:

Nineteen men who switched AA administration from without food to with food and 41 patients who administered AA without food only were included in the study. Of those patients who took AA with food at PSA progression, a PSA decline was observed in 3 of the 19 (16%) men, including 3 of the 14 men who had an initial response to AA (21%). Testosterone declined in five out of seven patients from pre-food levels. The median time on AA therapy was increased by nearly 100 days in patients who switched AA administration from without food to with food. No increases in toxicity were observed.

Conclusion:

Some men with mCRPC may benefit from taking AA with food. Further prospective comparative studies are needed to determine if changing AA administration is beneficial.

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Acknowledgements

We thank John Pura, MPH and Maragatha Kuchibhatla, PhD for statistical support and Ceci Chamorro for database management. No funding was obtained for this research.

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Authors and Affiliations

  1. Department of Pharmacy, Duke University Hospital, Durham, NC, USA

    J T Stover & R A Moore

  2. Division of Medical Oncology and Urology, Departments of Medicine and Surgery, Duke Cancer Institute, Durham, NC, USA,

    K Davis, M R Harrison & A J Armstrong

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  1. J T Stover
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  2. R A Moore
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Corresponding author

Correspondence to A J Armstrong.

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Competing interests

AJA receives research support, serves on the advisory board, and is a consultant for Janssen Pharmaceutica, the manufacturer of abiraterone acetate. MRH receives research support from Janssen Pharmaceutica. JTS, RAM and KD declare no conflicts of interest.

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Stover, J., Moore, R., Davis, K. et al. Reversal of PSA progression on abiraterone acetate through the administration with food in men with metastatic castration-resistant prostate cancer. Prostate Cancer Prostatic Dis 18, 161–166 (2015). https://doi.org/10.1038/pcan.2015.7

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