title: What Predicts Minimal Response to Abiraterone in Metastatic Castrate-resistant Prostate Cancer?
abstract: BACKGROUND
  Several treatments have been shown to prolong survival in metastatic castrate-resistant prostate cancer (mCRPC); the optimum sequencing of these is not established. We investigated methods of identifying patients with mCRPC unlikely to respond to abiraterone.
  
  
  METHODS
  A retrospective analysis was carried-out in 47 consecutive patients with mCRPC treated sequentially with androgen deprivation (LHRHa), bicalutamide, docetaxel then abiraterone.
  
  
  RESULTS
  The median progression-free survival in patients treated with abiraterone was shorter in those with ≤18 months' response to LHRHa (118 vs. 279 days; p=0.018), bicalutamide non-responders (91 vs. 196 days; p=0.003) and patients with ≤6 months' response to docetaxel (102 vs. 294 days; p<0.001). The median overall survival was also shorter (348 vs. 815 days, p=0.016; 413 vs. 752 days, p=0.009; and 325 vs. 727 days, p<0.04, respectively).
  
  
  CONCLUSIONS
  A response of ≤18 months' to LHRHa, non-response to bicalutamide and ≤6 months' response to docetaxel predicted poor response to abiraterone.
authors.affiliation: Velindre Cancer Centre, Cardiff, Wales, U.K. rhian.s.davies@wales.nhs.uk.
authors.forename: Rhian Siân
authors.initials: RS
authors.lastname: Davies
authors.affiliation: Velindre Cancer Centre, Cardiff, Wales, U.K.
authors.forename: Christian
authors.initials: C
authors.lastname: Smith
authors.affiliation: Velindre Cancer Centre, Cardiff, Wales, U.K.
authors.forename: Michael Robert
authors.initials: MR
authors.lastname: Button
authors.affiliation: Velindre Cancer Centre, Cardiff, Wales, U.K.
authors.forename: Jacob
authors.initials: J
authors.lastname: Tanguay
authors.affiliation: Velindre Cancer Centre, Cardiff, Wales, U.K.
authors.forename: Jim
authors.initials: J
authors.lastname: Barber
authors.affiliation: Velindre Cancer Centre, Cardiff, Wales, U.K.
authors.forename: Nachiappan
authors.initials: N
authors.lastname: Palaniappan
authors.affiliation: Velindre Cancer Centre, Cardiff, Wales, U.K. Institute of Cancer Genetics, Cardiff University, Cardiff, Wales, U.K.
authors.forename: John
authors.initials: J
authors.lastname: Staffurth
authors.affiliation: Velindre Cancer Centre, Cardiff, Wales, U.K.
authors.forename: Jason Francis
authors.initials: JF
authors.lastname: Lester
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000726:Androgen Antagonists / Q000627:therapeutic use*; D000736:Androstenes / Q000627:therapeutic use*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D064129:Prostatic Neoplasms, Castration-Resistant / Q000188:drug therapy* / Q000401:mortality* / Q000473:pathology; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D000726:Androgen Antagonists; D000736:Androstenes; C089740:abiraterone
keywords: Metastatic; abiraterone; castrate-resistant; drug sequencing; predictors response; prostate cancer