4.5 Article

Abiraterone Acetate, A Novel Adrenal Inhibitor in Metastatic Castration-Resistant Prostate Cancer

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CURRENT ONCOLOGY REPORTS
卷 13, 期 2, 页码 92-96

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SPRINGER
DOI: 10.1007/s11912-011-0153-4

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Castration-resistant prostate cancer; Hormonal manipulation; Adrenal synthesis; CYP17 inhibition; Abiraterone

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The androgen receptor remains the key player in patients with castration-resistant prostate cancer (CRPC). Available agents capable of blocking early adrenal androgen production have limited activity and can lead to significant toxicities. Abiraterone acetate, a pregnenolone analog, is a small molecule that irreversibly inhibits CYP17, a rate-limiting enzyme in androgen biosynthesis. Several clinical trials have demonstrated the safety and efficacy of this compound in men with metastatic CRPC. Recently, a randomized phase 3 trial evaluating abiraterone acetate in docetaxel-refractory CRPC patients demonstrated a survival improvement over placebo-treated patients (14.8 vs 10.9 months; HR 0.646; P < 0.0001). A similar trial in the pre-chemotherapy setting has completed accrual and is undergoing analysis. Here we review the rationale and clinical development of abiraterone acetate in men with CRPC.

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