Abiraterone for prostate cancer
I have prostate cancer and have heard about a drug called abiraterone. Can you tell me what it is and whether I can have it?
Abiraterone is a newer type of hormone therapy for advanced prostate cancer. It is also called CB7630, abiraterone acetate or Zytiga. It is a tablet you take once a day with a steroid called prednisolone.
It works in a different way to other hormone treatments for prostate cancer. The male hormone testosterone stimulates prostate cancers to grow. Stopping the body making testosterone can slow the growth of the cancer, or even shrink it. Most testosterone is made by the testes but a small amount is made by other tissue in the body including the cancer itself. To make testosterone the body needs an enzyme called cytochrome P17 (CYP17). Abiraterone acetate blocks this enzyme, which stops both the testes and other tissues in the body making testosterone.
You can find information about the side effects of abiraterone in the cancer drugs section.
Abiraterone was licensed by the European Medicines Agency (EMA) in September 2011 for use within Europe. It is for men who have advanced prostate cancer and have had other types of hormone therapy and docetaxel chemotherapy which is no longer working.
The governing bodies in UK that review which treatments should be available within the NHS say that abiraterone should be available for men whose cancer is growing after or during treatment with the chemotherapy docetaxel. You have it with prednisolone or prednisone.
You may also be able to have abiraterone as part of a clinical trial.
Early phase trials showed that abiraterone could lower levels of prostate specific antigen (PSA) in the blood for men with advanced prostate cancer. In some of the men their tumours shrank.
A large phase 3 trial called COU-AA-301 started in May 2008. It stopped recruiting patients in April 2009. The aim of the trial was to find out how well abiraterone worked for men who had already had hormone therapy and chemotherapy for prostate cancer that had spread. It was a randomised trial. The men taking part were put into treatment groups by a computer. One group of men had abiraterone once a day and a steroid called prednisolone twice a day. The other group took a dummy (placebo) tablet once a day and prednisolone twice a day.
Results of the COU-AA-301 trial presented at a conference in October 2010 showed that on average, the men who had abiraterone lived about 4 months longer than the men who had the dummy tablet. They also found that the PSA levels in the men who had abiraterone were more likely to fall and on average it took longer for their prostate cancer to start growing again.
So abiraterone can help to control advanced prostate cancer for a time in some men. At the moment though, the studies have been in men with very advanced disease. So it is too early to say exactly how helpful this drug may be in treating men with earlier stage prostate cancer. Larger studies are planned.
Another phase 3 trial called COU-AA-302 aims to find out how well the combination of abiraterone and prednisolone works for men who have previously had hormone therapy but not chemotherapy. This trial has finished recruiting patients, but the results are not known yet.
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