Dr. Ryan on Neoadjuvant Abiraterone Acetate

Charles J. Ryan, MD, medical oncologist, University of California San Francisco Helen Diller Family Comprehensive Cancer Center, discusses a recent clinical trial presented at the 2012 ASCO Annual Meeting that investigated the neoadjuvant administration of abiraterone acetate (Zytiga) in combination with leuprolide acetate for patients with localized high-risk prostate cancer.

Ryan notes that this trial was not designed to suggest whether a drug treatment could replace surgery or radiation, particularly since the trial assessed the efficacy of the treatment by indicators in the excised tissue. However, this trial could help establish the effectiveness of the combination earlier in the disease course.

Patients with prostate cancer who are potentially curable but have a reasonably high rate of recurrence may benefit the most from these treatments, Ryan believes. Many of these patients are treated with curable intent but there is generally a 25-30% chance of recurring. Providing the combination of abiraterone acetate and leuprolide acetate before surgery may help improve these recurrence rates.

Results from the neoadjuvant trial have created a foundation for future trials, but Ryan notes these studies take a long time to complete and would still need to be planned and executed.