Dr. Graff on the Use of Abiraterone in Metastatic Prostate Cancer

Julie N. Graff, MD, assistant professor of medicine, OHSU Knight Cancer Institute, discusses treatment for patients with high-risk metastatic disease following the FDA approval of abiraterone acetate (Zytiga).

Phase III results from the LATITUDE trial led to the approval of abiraterone acetate plus prednisone in patients with newly diagnosed high-risk metastatic hormone-naïve prostate cancer.

In high-risk patients, Graff advises physicians use, or at least offer, abiraterone in newly diagnosed metastatic disease. Physicians now know that men who are high risk with visceral disease, many bone metastases, and high Gleason scores can live longer with early use of abiraterone.

Graff notes that it may not be the standard of care for these patients. Although there are no direct studies comparing the use of abiraterone to the use of chemotherapy, Graff states that chemotherapy may be a better alternative for these patients. There’s a financial incentive for patients because chemotherapy is comparatively cheaper to abiraterone. Also, chemotherapy has a shorter and more defined regimen, whereas abiraterone is given until the cancer progresses.