What Predicts Minimal Response to Abiraterone in Metastatic Castrate-resistant Prostate Cancer?

Anticancer Res. 2015 Oct;35(10):5615-21.

Abstract

Background: Several treatments have been shown to prolong survival in metastatic castrate-resistant prostate cancer (mCRPC); the optimum sequencing of these is not established. We investigated methods of identifying patients with mCRPC unlikely to respond to abiraterone.

Patients and methods: A retrospective analysis was carried-out in 47 consecutive patients with mCRPC treated sequentially with androgen deprivation (LHRHa), bicalutamide, docetaxel then abiraterone.

Results: The median progression-free survival in patients treated with abiraterone was shorter in those with ≤18 months' response to LHRHa (118 vs. 279 days; p=0.018), bicalutamide non-responders (91 vs. 196 days; p=0.003) and patients with ≤6 months' response to docetaxel (102 vs. 294 days; p<0.001). The median overall survival was also shorter (348 vs. 815 days, p=0.016; 413 vs. 752 days, p=0.009; and 325 vs. 727 days, p<0.04, respectively).

Conclusion: A response of ≤18 months' to LHRHa, non-response to bicalutamide and ≤6 months' response to docetaxel predicted poor response to abiraterone.

Keywords: Metastatic; abiraterone; castrate-resistant; drug sequencing; predictors response; prostate cancer.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Androgen Antagonists / therapeutic use*
  • Androstenes / therapeutic use*
  • Disease-Free Survival
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Grading
  • Neoplasm Staging
  • Prostatic Neoplasms, Castration-Resistant / drug therapy*
  • Prostatic Neoplasms, Castration-Resistant / mortality*
  • Prostatic Neoplasms, Castration-Resistant / pathology
  • Retrospective Studies
  • Survival Rate

Substances

  • Androgen Antagonists
  • Androstenes
  • abiraterone