The addition of Zytiga® (abiraterone) to prednisone significantly delayed patient-reported pain progression and health-related quality-of-life deterioration compared with prednisone alone in chemotherapy-naive men with metastatic castration-resistant prostate cancer, according to the results of a study published in The Lancet Oncology.
Prostate cancer is a hormonally sensitive disease that can often be controlled for long periods with androgen-deprivation therapy (ADT). When prostate cancer stops responding to this treatment, it is referred to as hormone-refractory prostate cancer. Metastatic hormone-refractory prostate cancer is a challenging form of the disease to treat because the cancer has spread to distant sites in the body and does not respond to treatment with standard hormonal therapy.
Zytiga is an oral targeted agent that blocks the production of androgens (male hormones such as testosterone) not only by the testes, but also by the adrenal glands and the tumor itself.
In an international, double-blind trial, 1,088 patients with progressive, metastatic castration-resistant prostate cancer were randomly assigned to receive Zytiga plus prednisone or prednisone plus placebo in continuous 4-week cycles. Researchers measured patients’ pain (with the Brief Pain Inventory Short Form [BPI-SF] questionnaire) and health-related quality of life (HRQoL) (with the Functional Assessment of Cancer Therapy-Prostate (FACT-P) questionnaire). The researchers then analyzed the data to evaluate clinically meaningful pain progression and deterioration in HRQoL.
At a median follow-up of 22.2 months, the median time to progression of mean pain intensity was significantly longer in patients receiving Zytiga/prednisone (26.7 months) than in those receiving prednisone/placebo (18.4 months). The median time to progression of pain interference with daily activities was also significantly longer in the Zytiga group—10.3 months compared to 7.4 months. What’s more, the median time to progression of worst pain intensity was also longer in the Zytiga/prednisone group (26.7 months) compared to the prednisone/placebo group (19.4 months), but the difference was considered non-significant.
The median time to HRQoL deterioration was longer in patients receiving Zytiga/prednisone (12.7 months) than in those receiving prednisone/placebo (8.3 months).
The researchers concluded that Zytiga plus prednisone delays patient-reported pain progression and HRQoL deterioration in chemotherapy-naive patients with metastatic castration-resistant prostate cancer.
Basch E, Autio K, Ryan CJ, et al: Abiraterone acetate plus prednisone versus prednisone alone in chemotherapy-naive men with metastatic castration-resistant prostate cancer: patient-reported outcome results of a randomised phase 3 trial. The Lancet Oncology. 2013; 14(12):1193-1199.
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