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Hormonal impact of the 17 alpha-hydroxylase/C-17,C-20-lyase inhibitor abiraterone acetate (CB7630) in patients with prostate cancer

O'Donnell, A; Judson, I; Dowsett, M; Raynaud, F; Dearnaley, D; Mason, M; Harland, S; ... Jarman, M; + view all (2004) Hormonal impact of the 17 alpha-hydroxylase/C-17,C-20-lyase inhibitor abiraterone acetate (CB7630) in patients with prostate cancer. British Journal of Cancer , 90 (12) pp. 2317-2325.

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Abstract

A series of three dose escalating studies were conducted to investigate the ability of the 17alpha-hydroxylase/ C-17,C-20- lyase inhibitor abiraterone acetate, to cause maximum suppression of testosterone synthesis when delivered to castrate and noncastrate males with prostate cancer. Study A was a single dose study in castrate males. Study B was a single dose study in noncastrate males and study C was a multiple dose study in noncastrate males. The drug was given orally in a once-daily dose and blood samples taken to assess pharmacokinetic (PK) parameters and hormone levels in all patients. The study drug was well tolerated with some variability in PKs. Suppression of testosterone levels to <0.14 nmol l(-1) was seen in four out of six castrate males treated with a single dose of 500 mg. At 800 mg given days 1 - 12 in noncastrate males, target suppression was achieved in three out of three patients, but a two- to threefold increase of Luteinising Hormone (LH) levels in two out of three patients overcame suppression within 3 days. All patients in the multiple dose study developed an abnormal response to a short Synacthen test by day 11, although baseline cortisol levels remained normal. This is the first report of the use of a specific 17&alpha;-hydroxylase/(17,20)-lyase inhibitor in humans. Repeated treatment of men with intact gonadal function with abiraterone acetate at a dose of 800 mg can successfully suppress testosterone levels to the castrate range. However, this level of suppression may not be sustained in all patients due to compensatory hypersecretion of LH. The enhanced testosterone suppression achieved in castrate men merits further clinical study as a second-line hormonal treatment for prostate cancer. Adrenocortical suppression may necessitate concomitant administration of replacement glucocorticoid

Type: Article
Title: Hormonal impact of the 17 alpha-hydroxylase/C-17,C-20-lyase inhibitor abiraterone acetate (CB7630) in patients with prostate cancer
Additional information: WoS ID: 000222427100010 JournalEnglishArticle22NATURE PUBLISHING GROUP*CANC RES UK, 2002, COMB STAT MORT STAT; BARRIE SE, 1997, J STEROID BIOCHEM, V60, P347; BARRIE SE, 1994, J STEROID BIOCHEM, V50, P267; BUBENDORF L, 1999, CANCER RES, V59, P803; DEMARIO MD, 1998, J CLIN ONCOL, V16, P2557; DENIS L, 1993, CANCER, V72, P3888; DENMEADE SR, 2002, NAT REV CANCER, V2, P389; DOWSETT M, 1988, BRIT J CANCER, V57, P190; EICHENBERGER T, 1988, AM J CLIN ONCOL-CANC, V11, PS104; GREGORY CW, 2001, CANCER RES, V61, P2892; GREGORY CW, 2001, CANCER RES, V61, P4315; GRIFFIN JE, 1998, WILLIAMS TXB ENDOCRI, P819; HARNETT PR, 1987, BRIT J UROL, V59, P323; HELLERSTEDT BA, 2002, CA-CANCER J CLIN, V52, P154; LINJA MJ, 2001, CANCER RES, V61, P3550; LONG BJ, 2000, CANCER RES, V60, P6630; LOOSE DS, 1983, J CLIN INVEST, V71, P1495; OH WK, 2002, UROLOGY S, V60, P87; POTTER GA, 1995, J MED CHEM, V38, P2463; ROSTOM AY, 1982, BRIT J UROL, V54, P552; ROWLANDS MG, 1995, J MED CHEM, V38, P4191; SCHWIMMER B, 1996, GOODMAN GILMANS PHAR, P14592JUN 14834RBLONDONJudson I Inst Canc Res, CR UK Ctr Canc Therepeut, E Block,15 Cotswold Rd, Sutton SM2 5NG, Surrey, EnglandBRIT J CANCERMACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND
Keywords: ABILITY, AMINOGLUTETHIMIDE, ANDROGEN, CANCER, CARCINOMA, clinical study, GENE, hormonal therapy, HORMONE LEVELS, INTACT, KETOCONAZOLE, pharmacokinetics, prostate cancer, PROSTATE-CANCER, response, SINGLE, STEROIDAL INHIBITORS, THERAPY
UCL classification: UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute > Research Department of Oncology
URI: http://discovery.ucl.ac.uk/id/eprint/70204
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