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Biochemical and objective response to abiraterone acetate withdrawal: Incidence and clinical relevance of a new scenario for castration-resistant prostate cancer

O. Caffo, A. Palermo, A. Veccia, F. Maines, F. Chierichetti, A. Berruti, E. Galligioni.

Urology, Volume 82, Issue 5, November 2013, Pages 1090-1093. 

Editor's comments

This, to the best of my knowledge , is the first report demonstrating an abiraterone withdrawal effect (similar to anti-androgen withdrawal). More data is required to better assess the potential of this phenomenon.



To describe the incidence and clinical relevance of biochemical and objective responses to abiraterone acetate (AA) withdrawal (AAWD) in patients with castration-resistant prostate cancer (CRPC).

Materials and Methods

Twenty-six patients with progressive CRPC treated with first-line docetaxel-based chemotherapy were administered with AA at the standard dose of 1000 mg/day in combination with prednisone until progression. The patients were regularly followed up during treatment and after AAWD.


Nineteen of the 26 patients discontinued AA because of progression. Three of the patients undergoing AAWD experienced a biochemical response, which was accompanied by a metabolic and radiological response as revealed by choline positron emission tomography in 2 cases.


Regardless of the underlying molecular bases, AAWD response does not occur rarely. It is sometimes long-lasting and accompanied by a metabolic and radiographic improvement. AAWD response should be taken into account when further therapeutic strategies are planned in patients with CRPC with progressive disease during abiraterone therapy.

© 2013 Elsevier Inc.



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