Use of abiraterone in patients with chemotherapy-naïve, metastatic castration resistant prostate cancer. A real life experience in Latin America

Abstract

Aim: To analyze the clinical experience with abiraterone acetate in chemotherapy naïve (CN) patients with metastatic castration resistant prostate cancer (mCRPC), on a real world scenario from a Medical Center at Mexico City.

Methods. An observational study of patients from the Urology Department, Centro Médico Nacional “20 de Noviembre”, ISSSTE; with CN-mCRPC was performed. Abiraterone acetate plus prednisone and leuprolide were administered during January 2014 to December 2016. The primary endpoints were time to radiological progression and global survival. Secondary endpoints (time to ECOG decline, time to cytotoxic chemotherapy initiation, time to analgesic use and time to PSA progression) were compared in subgroups divided by Gleason score.

Results. Eighteen patients received Abiraterone acetate. Radiographic progression was observed after 7 and 10 months (2 cases, 11.1%); while death (1 case, 5.5%) ocurred after 9 months. Early analgesic use was frequent (>50% at 10 months); while disease progression, reflected by either initiation of chemotherapy, higher ECOG scores or PSA values, ocurred in <50%. In addition, we observed a trend for earlier initiation of chemotherapy, ECOG progression and analgesic use if Gleason score was >7. Thirteen (72.2%) patients showed adverse events like fatigue, back pain, hot flushes and others; none of them were fatal.

Conclusion. Abiraterone acetate therapy resulted in similar endpoints of efficacy and safety in the study patients, on a real world scenario; as compared to previous reports from literature. Therefore, abiraterone acetate may be a valuable therapeutic option for similar populations.