[Abiraterone in castration resistant prostate cancer.]

OBJECTIVES: Prostate cancer is the most frequent neoplasia diagnosed in males. Treatment of metastatic prostate cancer is based on androgen deprivation therapy (ADT) up to its change to the castration resistance state. Recently, new molecules have been developed that significantly increase survival and quality of life of these patients. Abiraterone acetate in combination with prednisone is the first oral hormone therapy that contributed to this change in the approach of the disease.

METHODS: Systematic bibliographic review about abiraterone in the treatment of metastatic castration resistant prostate cancer (CPRC), with data on efficacy, safety and quality of life.

RESULTS: Treatment with abiraterone and prednisone has demonstrated a significant increase in overall survival (OS 34.7 vs 30.3 months) and radiologic progression free survival (RPFS 16.5 months vs 8.3 months) in comparison to placebo and prednisone in patients with metastatic castration resistant prostate cancer (mCPRC). It also demonstrated an increase in OS and RPFS compared to placebo plus prednisone in mCPRC patients after at least one cytotoxic chemotherapy based treatment (OS 15.8 vs 11.2 months; RPFS 5.6 vs 3.6 months). Side effects related to abiraterone therapy are mainly related with mineral corticoid excess (Hypertension, hypokalemia, fluid retention) and, to a lesser extent, transaminase alterations or cardiovascular effects. Perceived quality of life results show a benefit in the abiraterone treatment group.

CONCLUSIONS: Abiraterone acetate is a new hormonal treatment for metastatic castration resistant prostate cancer both before and after chemotherapy. The results of the available studies demonstrate a significant improvement in terms of efficacy, with a tolerability profile generally acceptable, predictable and manageable, and an improvement in patient's perceived quality of life.