Dr. Burgess on the Synergy Between Abiraterone and ADT in Prostate Cancer

Earle Burgess, MD, associate professor of medicine, Levine Cancer Institute, discusses the synergy between abiraterone acetate (Zytiga) and androgen deprivation therapy (ADT) in prostate cancer.

Abiraterone inhibits adrenal steroid agenesis, explains Burgess. In a patient with castrate-resistant or castrate-sensitive prostate cancer, testicular androgen production is slowed or stopped. The low volume of adrenal steroid agenesis becomes biologically relevant to the growth and progression of prostate cancer, notes Burgess. Abiraterone essentially turns off adrenal steroid agenesis, which has been shown to reflect an improvement in patients with castrate-resistant prostate cancer, says Burgess.

Through the LATITUDE trial and the abiraterone arm of the STAMPEDE trial, physicians showed that earlier introduction of abiraterone reflects a greater magnitude of benefit for patients. That is likely due to the additional blockade of adrenal androgen production, says Burgess. The synergy with ADT then, likely comes from the maximal androgen blockade, he concludes.