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Updated: May 25, 2026
Murine Prostate Micro-dissection and Surgical Castration
Published on: May 11, 2016
[Inhibitors of androgen and estrogen biosynthesis in castration-resistant prostate cancer]
1The Institute of Cancer Research, The Royal Marsden NHS Foundation Trust, Sutton, England.
Abstract:
Advanced prostate cancer remains dependent on androgens and signaling through the androgen receptor despite castrate levels of testosterone defined as testosterone levels <1.7 nmol/l. Ketoconazole, a nonspecific inhibitor of androgen synthesis, has been tested in clinical trials and showed clinical activity; however, high doses are needed which are associated with significant sides effects, mainly neurotoxicity, gastrointestinal intolerance, and liver toxicity. Abiraterone acetate is an irreversible inhibitor of two key enzymes of androgen synthesis, 17a-hydroxylase and 17,20-lyase, and has been tested in a randomized phase III study in patients with castration-resistant prostate cancer who progressed after chemotherapy. Abiraterone plus prednisone resulted in a significant overall survival benefit of 4.6 months compared to prednisone alone. Abiraterone was well tolerated, with mostly mild or moderate side effects consistent with secondary mineralocorticoid excess, namely fluid retention, hypokalemia, and hypertension. Abiraterone plus prednisone is considered a new standard therapy option for patients with castration-resistant prostate cancer who progressed after chemotherapy.
Insights
Advanced prostate cancer treatment improved with abiraterone acetate, offering a 4.6-month survival benefit in patients with castration-resistant prostate cancer. This new therapy option is well-tolerated and effective.
Area of Science:
- Oncology
- Endocrinology
- Pharmacology
Context:
- Advanced prostate cancer relies on androgen signaling, even at low testosterone levels.
- Previous treatments like ketoconazole showed activity but had significant side effects.
- Castration-resistant prostate cancer (CRPC) progression after chemotherapy necessitates new therapeutic strategies.
Purpose:
- To evaluate the efficacy and safety of abiraterone acetate plus prednisone in patients with metastatic castration-resistant prostate cancer (mCRPC) who have progressed after docetaxel-based chemotherapy.
- To assess the overall survival benefit of abiraterone acetate in this patient population.
Summary:
- Abiraterone acetate, an inhibitor of androgen synthesis enzymes (17α-hydroxylase and 17,20-lyase), was studied in a Phase III trial.
- Patients receiving abiraterone acetate plus prednisone demonstrated a significant improvement in overall survival (4.6 months) compared to prednisone alone.
- Abiraterone acetate was generally well-tolerated, with manageable side effects related to mineralocorticoid excess.
Impact:
- Abiraterone acetate plus prednisone represents a new standard of care for patients with CRPC post-chemotherapy.
- The findings support abiraterone acetate as an effective and tolerable treatment option for advanced prostate cancer.
- This study highlights the importance of targeting androgen synthesis in overcoming treatment resistance in prostate cancer.
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