title: The role of abiraterone acetate in the management of prostate cancer: a critical analysis of the literature.
abstract: BACKGROUND
  The development of agents targeting androgen signalling holds promise for men with castration-resistant prostate cancer (CRPC).
  
  
  OBJECTIVE
  The emerging role of abiraterone acetate (AA), a novel, orally administered androgen synthesis inhibitor, is critically analysed.
  
  
  METHODS
  Data were acquired from critically important original research published in peer-reviewed literature or presented at conferences conducted by the American Society of Clinical Oncology and the European Society of Medical Oncology.
  
  
  RESULTS
  The major findings are addressed in an evidence-based, objective, and balanced fashion.
  
  
  CONCLUSIONS
  AA specifically inhibits CYP17 and substantially reduces serum androgen levels without inducing significant adrenal insufficiency. A phase 3 trial reported a significant extension of survival in metastatic CRPC with AA plus prednisone compared to prednisone alone following docetaxel. The primary toxicity of mineralocorticoid excess is manageable. The addition of low-dose corticosteroids to AA may be necessary for controlling symptoms of mineralocorticoid excess.
authors.affiliation: Veterans Affairs Medical Centre and the Baylor College of Medicine, Houston, TX, USA.
authors.forename: Guru
authors.initials: G
authors.lastname: Sonpavde
authors.forename: Gerhardt
authors.initials: G
authors.lastname: Attard
authors.forename: Joaquim
authors.initials: J
authors.lastname: Bellmunt
authors.forename: Malcolm D
authors.initials: MD
authors.lastname: Mason
authors.forename: Bernard
authors.initials: B
authors.lastname: Malavaud
authors.forename: Bertrand
authors.initials: B
authors.lastname: Tombal
authors.forename: Cora N
authors.initials: CN
authors.lastname: Sternberg
mesh_terms: D000726:Androgen Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D000736:Androstenes; D000737:Androstenols / Q000009:adverse effects / Q000627:therapeutic use*; D018931:Antineoplastic Agents, Hormonal / Q000009:adverse effects / Q000627:therapeutic use*; D004791:Enzyme Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D019317:Evidence-Based Medicine; D006801:Humans; D008297:Male; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000201:enzymology / Q000401:mortality / Q000473:pathology; D013254:Steroid 17-alpha-Hydroxylase / Q000037:antagonists & inhibitors* / Q000378:metabolism; D016896:Treatment Outcome
chemical_list: D000726:Androgen Antagonists; D000736:Androstenes; D000737:Androstenols; D018931:Antineoplastic Agents, Hormonal; D004791:Enzyme Inhibitors; D013254:Steroid 17-alpha-Hydroxylase; C089740:abiraterone