Abstract
Abiraterone acetate (AA) is a first-in-class CYP17 (17α-hydroxylase/C17, 20 lyase) inhibitor that is approved for the treatment of metastatic castration-resistant prostate cancer (mCRPC). AA prolonged overall survival in both mCRPC patients with or without previously chemotherapy by two randomized Phase III studies (COU-AA-301 and 302 trial). In Japan, AA approved in 2014, similar efficacy and safety of AA are demonstrated. Prostate-specific antigen (PSA) response rates were 60.4% in chemotherapy naïve mCRPC patients (JPN-201 study) and 28.3% in post-chemotherapy mCRPC patients (JPN-202 study), respectively. The most common were liver dysfunction and mineralocorticoid-related adverse events such as hypokalemia, hypertension, and edema. Majority of the adverse events were grade 1 or 2 in severity. PSA flare phenomenon observed approximately 10% during AA treatment, which is feature and different from that of enzalutamide. There is no clear answer to sequential androgen receptor-axis-targeted therapy. But, AA to enzalutamide sequence may be better outcome for PSA progression-free survival compared with reverse sequence. Even in elderly patients with mCRPC, if the patients can be treated, they can be safe and obtain the sufficient therapeutic effect. However, there is no report of AA treatment in Japanese elderly mCRPC patients. This review evaluated the use of AA for Japanese mCRPC patients in detail.
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Ikeda, M., Satoh, T. (2018). Abiraterone Acetate Therapy for mCRPC in Japanese Men. In: Arai, Y., Ogawa, O. (eds) Hormone Therapy and Castration Resistance of Prostate Cancer. Springer, Singapore. https://doi.org/10.1007/978-981-10-7013-6_25
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