Taking abiraterone acetate with and without food: some new data


A new paper in the journal Prostate Cancer and Prostatic Diseases suggests that, at least for some men, disease progression while on abiraterone acetate may be (temporarily) reversible when they take the drug with food as opposed to without food (the latter being the standard recommendation).

Stover et al. carried out a retrospective analysis of data from a cohort of 60 patients with metastatic, castration-resistant prostate cancer (mCRPC), all being treated at Duke Medical Center with abiraterone acetate between April 1, 2011 and December 31, 2013. Their primary objective was to explore the effects of taking abiraterone with food among men who had previously been taking the drug in the standard manner, i.e., without food.

Here are their basic findings:

  • 19/60 patients switched from taking abiraterone without food to with food at PSA progression.
  • 41/60 patients took abiraterone only without food.
  • 3/19 patients (16 percent) who switched to taking abiraterone with food at PSA progression exhibited a subsequent PSA decline.
  • This decline was observed in 3/14 patients who had had an initial response to abiraterone.
  • Serum testosterone declined in 5/7 patients from pre-food levels.
  • Average (median) time on abiraterone therapy was increased by nearly 100 days in patients who switched from without to with food.
  • There was no evidence of increased toxicity.

In commentary about this study on the Renal & Urology News web site, it is also noted that “prior treatment with ketoconazole might have contributed to the low proportion of patients experiencing a PSA decline after switching to taking [abiraterone acetate] with food, according to the investigators.”

The question of whether taking abiraterone with or without food is “better” for some men is not yet fully resolved, and patients would be unwise to take action on their own without some prior discussion with their clinicians. It is believed that when one takes abiraterone acetate with food may be leading to the inhibition of additional enzymes in patients who respond positively to this strategy.

One Response

  1. I know for a fact that Chuck Ryan at UCSF, one of the principal investigators in trials of abiraterone, has recommended abiraterone with food to his patients in certain cases — for example when a friend was temporarily unable to replenish his supply.

    Abiraterone is, I believe, processed through the liver and is more toxic with food. A study is being conducted on the effectiveness of 1,000 versus 2,000 mg, although I don’t think results are published yet.

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