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Low Incidence of Corticosteroid-associated Adverse Events on Long-term Exposure to Low-dose Prednisone Given with Abiraterone Acetate to Patients with Metastatic Castration-resistant Prostate Cancer.

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Date
2016-09
ICR Author
De Bono, Johann
Author
Fizazi, K
Chi, KN
de Bono, JS
Gomella, LG
Miller, K
Rathkopf, DE
Ryan, CJ
Scher, HI
Shore, ND
De Porre, P
Londhe, A
McGowan, T
Pelhivanov, N
Charnas, R
Todd, MB
Montgomery, B
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Type
Journal Article
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Abstract
Background Abiraterone acetate (AA) is the prodrug of abiraterone, which inhibits CYP17A1 and testosterone synthesis and prolongs the survival of patients with metastatic castration-resistant prostate cancer (mCRPC). AA plus prednisone (P) (AA+P) is approved for the treatment of patients with mCRPC.Objective To investigate whether long-term use of low-dose P with or without AA leads to corticosteroid-associated adverse events (CA-AEs) in mCRPC patients.Design, setting, and participants The study included 2267 patients in COU-AA-301 and COU-AA-302. We used an inclusive Standardized MedDRA Queries-oriented approach to identify 112 preferred terms for known CA-AEs, and assessed the incidence of CA-AEs during 3-mo exposure intervals and across all P exposure levels.Intervention All 2267 patients received 5mg of P twice daily, and 1333/2267 received AA (1g) plus P.Results and limitations The CA-AE incidence after any P exposure was 25%, 26%, and 23% for any grade, and 5%, 5%, and 4% for grade ≥3 CA-AEs for all patients and the AA+P and P alone groups, respectively. The most common any-grade CA-AEs were hyperglycemia (7.4%, 7.8%, and 6.9% for all patients, AA+P, and P alone, respectively) and weight increase (4.3%, 3.9%, and 4.8%, respectively). When assessed by duration of exposure (3-mo intervals up to ≥30 mo), no discernable trend was observed for CA-AEs, including hyperglycemia and weight increase. The investigator-reported study discontinuation rate due to CA-AEs was 11/2267 (0.5%), and one patient had a CA-AE resulting in death.Conclusions Low-dose P given with or without AA is associated with low overall incidence of CA-AEs. The frequency of CA-AEs remained low with increased duration of exposure to P.Patient summary We assessed adverse events in patients with metastatic castration-resistant prostate cancer during long-term treatment with a low dose of a corticosteroid. We found that long-term treatment with this low-dose corticosteroid is safe and tolerable.
URI
https://repository.icr.ac.uk/handle/internal/453
DOI
https://doi.org/10.1016/j.eururo.2016.02.035
Collections
  • Clinical Studies
Subject
Humans
Hyperglycemia
Weight Gain
Prednisone
Antineoplastic Combined Chemotherapy Protocols
Time Factors
Adult
Aged
Aged, 80 and over
Middle Aged
Male
Prostatic Neoplasms, Castration-Resistant
Abiraterone Acetate
Research team
Prostate Cancer Targeted Therapy Group
Language
eng
Date accepted
2016-02-10
License start date
2016-09
Citation
European urology, 2016, 70 (3), pp. 438 - 444

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