Quality of Life and Survival in Advanced Prostate Cancer Patients with Abiraterone

In a recent interview with Dr. Leonard Gamella at the Kimmel Center at Jefferson, he discussed the final results of the phase three COU 3O2 study that were just presented at the ESMO meeting in Madrid.

This was the longterm study of the Aberraterone 3O2 trial that looked at the use of Aberraterone before docetaxel chemotherapy and men with metastatic castrate resistant prostate cancer.

And this long term data showed convincingly that there was a benefit to using abiraterone with Prednisone in this patient population. What was very important about the study is that the final analysis was about a 34.7 month survival in the treated group versus about 30 point three months in the placebo.

Arm of the study which was just Prednisone. So this convincingly shown that there is a survival advantage to using abiraterone in this patient population. In this particular Cougar 302 study there was a there was a crossover about 66% or about the 2/3 of the men.

In the the treatment arm in about 80% of the men in the placebo arm ended up crossing over to the Aberraterone arm. So they ended up getting actual treatment. What was very important about it is that regardless of whether you were in the treatment arm or the placebo arm, the fact that the subsequent treatment really did not make a difference, the results held true that the use of aberraterone did extend to survival even in those that were in the crossover arm.

Concerning starting the the use of these agents for a metastatic history resistant prostate cancer, we probably like to start them within a month or two. Sometimes you know three or four months can make a difference. So you want to try to get these agents on board as early as possible. The take home messages of using the abiraterone in in these patients is that really a lot of it has to do with quality of life and survival.

Some of the benefits in this particular trial of using abiraterone really related to the delayed use of opioids sometimes as long as he possibly is 12 months or longer, meaning that men are not having discomfort, they're not suffering a lot of morbidity from prostate cancer and their quality of life is is greatly improved. So it's good that we now have these agents that we can use in patients that are relatively.

Well tolerated side effects profiles are really very, very limited. You do have to monitor liver function tests and some basic chemistry parameters, but overall the drugs are very well tolerated and give a good quality of life to men who have an otherwise very difficult situation.