Abstract
Introduction: This is a retrospective analysis to assess the safety and efficacy of abiraterone
acetate (AA) in metastatic castrate-resistant prostate cancer (mCRPC) patients treated
at tertiary care institute. Materials and Methods: The clinical records of mCRPC patients treated with AA at our tertiary care institute
between July 2013 and December 2015 were reviewed. The treatment efficacy, toxicities,
and its determinants were analyzed. Results: A total of 59 mCRPC patients treated with AA were reviewed, of whom 37 were chemo-naive
and 22 had received prior chemotherapy (postchemo). The median follow-up duration
was 10.0/15.0 months for chemo-naïve/postchemotherapy patients. 43.2%/36.36% of chemo-naive/postchemo
patients had visceral metastases. The median overall survival (OS) and progression-free
survival (PFS) were 15/7.8 months and 10/5.3 months for chemo-naive/postchemo patients,
respectively. Median time to best prostate-specific antigen response was 3.4 months.
Abiraterone was relatively well tolerated with no grade 4 toxicity or treatment-related
death. We found the presence of previous taxene use and baseline symptoms to be significantly
determinant of OS with abiraterone. Conclusion: The present study reported the efficacy of abiraterone in both chemo-naïve and postchemo
patients of mCRPC outside clinical trial setting. We found lower OS and PFS with abiraterone
as compared to that reported in the clinical trial setting in both chemo-naïve and
postchemo patients, and particularly in those patients with the visceral disease,
and further clinical trial for abiraterone in this subgroup of patients is warranted.
Key words
Abiraterone - chemo-naive/postchemo - metastatic castrate-resistant prostate cancer
- nontrial setting - visceral disease
