CONTEXT: Prostate cancer treatment remains a challenge for the urologist.
Medical control in locally advanced or metastatic prostate cancer is usually performed with LHRH analogues and/or antiandrogens. Different treatments have been proposed when there is biochemical and clinical progression of the disease and other new ones have changed the patients' perspective and life expectancy.
OBJECTIVE: This review has aimed to establish the current role of Abiraterone Acetate in the treatment of castration-resistant prostate cancer and facilitate decision-making by the Urologist by means of a Treatment Algorithm.
ACQUISITION OF THE EVIDENCE: A search of current evidence on Abiraterone treatment in patients with castration- resistant metastatic prostate cancer was performed in PubMed, mainly analyzing those studies designed as clinical trials. In addition, we reviewed and updated the role of hormone therapy and androgen receptors in prostate cancer.
EVIDENCE SYNTHESIS: There are currently basically two clinical trials that demonstrate the effectiveness of Abiraterone in metastatic prostate cancer compared to placebo. The study COU-AA 302 shows a clear benefit with Abiraterone prior to chemotherapy in patients with castration-resistant prostate cancer, this making it possible to establish an algorithm for initial treatment that facilitates decision-making by the urologist.
CONCLUSION: Abiraterone is a pre-chemotherapy treatment option in selected patients with castration resistant metastatic prostate cancer, although it is necessary to improve the cost and to design more multicenter clinical trials to optimize the cost/benefit ratio.
Written by:
Arrabal-Martín M, Anglada-Curado F, Cózar-Olmo JM, Soler-Martínez J, Moreno-Jiménez J, Castiñeiras-Fernández J, Ledo-Cepero MJ, Beardo-Villar P, Requena-Tapia MJ, Zuluaga-Gómez A; Grupo AAyEU. Are you the author?
UGC de Urología, Hospital Universitario San Cecilio, Instituto de Investigación Biosanitaria de Granada, Granada, España; UGC de Urología, Hospital Universitario Reina Sofía, Córdoba, España; UGC de Urología, Hospital Universitario Virgen de las Nieves, Granada, España; UGC de Urología, Hospital Regional Carlos Haya, Málaga, España; UGC de Urología, Hospital Universitario Ciudad de Jaén, España; UGC de Urología, Hospital Universitario Macarena, Sevilla, España; UGC de Urología, Hospital Universitario Puerta del Mar, Cádiz, España; UGC de Urología, Hospital de Jerez de la Frontera, Cádiz, España; UGC de Urología, Hospital Universitario San Cecilio, Instituto de Investigación Biosanitaria de Granada, Granada, España.
Reference: Actas Urol Esp. 2013 Dec 15. pii: S0210-4806(13)00380-X.
doi: 10.1016/j.acuro.2013.10.008
PubMed Abstract
PMID: 24342031
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