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Abiraterone acetate treatment in patients with castration-resistant prostate cancer with visceral metastases

a real-world experience

Facchini, Gaetanoa; Cavaliere, Carlac; D’Aniello, Carmineb; Iovane, Gelsominaa; Rossetti, Sabrinaa

doi: 10.1097/CAD.0000000000000703

In the pre-chemotherapy (CT) and post-CT settings of metastatic castration-resistant prostate cancer (mCRPC), abiraterone acetate plus prednisone (AAP) significantly extended median overall survival and radiographic progression-free survival (PFS) compared with prednisone alone. Yet, few data are available on therapy efficacy in the subgroup with visceral metastases, who represent a small population with poor prognosis. The aim of this study was to describe the clinical experience of AAP in patients with mCRPC with liver and/or lung metastases in real-world setting. We retrospectively reviewed the clinical records of patients with mCRPC with liver and/or lung metastases treated at the National Cancer Institute ‘Fondazione G. Pascale’ from September 2011 to May 2017. Co-primary end points were overall survival and radiographic PFS. Survival estimates were computed using Kaplan–Meier method. Secondary end points were response rate and safety. Of 143 patients with mCRPC treated, 18.9% (N=27) had visceral metastases: 85.2% (N=23) of the lung, 11.1% (N=3) of the liver and 3.7% (N=1) of both. Median PFS was 13.1 months [95% confidence interval (CI): 4.8–NA] in the pre-CT setting (N=11, median follow-up: 12.9 months), and 10.5 months (95% CI: 4.4–16.6) in the post-CT setting (N=16, median follow-up: 17.2 months). Pre-CT and post-CT patients with lung metastases had a median PFS of 16.5 months (95% CI: 4.3–NA) and 11.4 months (95% CI: 4.2–17.0), respectively. AAP tolerability was consistent with that previously reported in patients with mCRPC, without new safety concerns. Our finding provides preliminary evidence that AAP in real-world setting is a potential effective and safe therapeutic option for patients with mCRPC with a more advanced disease associated with the presence of visceral metastases, in both the pre-CT and post-CT settings.

aDepartmental Unit of Clinical and Experimental Uro-Andrologic Oncology, Istituto Nazionale Tumori, IRCCS, Fondazione G. Pascale

bDivision of Medical Oncology, A.O.R.N. dei COLLI ‘Ospedali Monaldi-Cotugno-CTO’, Napoli

cUOC of Medical Oncology, ASL NA3 SUD, Ospedali Riuniti Area Nolana, Nola, Italy

Correspondence to Gaetano Facchini, MD, Istituto Nazionale Tumori, IRCCS, Fondazione G. Pascale, Via M. Semmola 80131, Napoli, Italy Tel: +39 081 590 3641; e-mail:

Received May 1, 2018

Accepted September 24, 2018

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