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Posted by on Nov 8, 2017 in Prostate cancer | 0 comments

In a nutshell

This study aimed to determine which patients  benefited most from abiraterone acetate (Zytiga) and prednisone (Deltasone). This study found that overall survival was increased for all patient groups that received this combination. 

Some background

A main treatment option for prostate cancer is androgen deprivation therapy. This blocks the male hormones, such as testosterone, responsible for cancer growth. Some patients may become resistant to this therapy, and may experience cancer spread. This is known as metastatic castration-resistant prostate cancer (mCRPC). There are several treatment options for mCRPC. One treatment, abiraterone acetate, acts by decreasing hormones that can act on prostate tissue. A steroid (prednisone) is often given with this drug. 

It is unclear which patients benefit the most from this treatment. 

Methods & findings

This study looked at the effect abiraterone acetate and prednisone (AAP) had on patients with mCRPC. AAP was compared to patients treated with a placebo (substance with no active effect) and prednisone. Patients were compared in terms of pain, Gleason score and PSA. Gleason score is a measure of cancer aggressiveness. Prostate-specific antigen (PSA) is a protein present in the blood with prostate cancer. 

AAP increased overall survival regardless of Gleason score, PSA level, or levels of pain. High levels of pain, a high Gleason score and a high PSA did lead to a lower overall survival (41.8 versus 53.6 months for those without symptoms and lower scores), but this effect was not due to AAP. 

The bottom line

This study concluded that AAP significantly improved outcomes in mCRPC compared with prednisone alone regardless of baseline pain and PSA level, and Gleason score at primary diagnosis.

The fine print

The evidence for making treatment decisions based on primary Gleason score, baseline pain or PSA is not strong in this paper. 

What’s next?

Discuss this treatment option with your doctor. 

Published By :

European Urology

Date :

Sep 19, 2017

Original Title :

The Phase 3 COU-AA-302 Study of Abiraterone Acetate Plus Prednisone in Men with Chemotherapy-naïve Metastatic Castration-resistant Prostate Cancer: Stratified Analysis Based on Pain, Prostate-specific Antigen, and Gleason Score.

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