Abiraterone acetate plus prednisone and androgen-deprivation therapy (ADT) are linked to improved patient-reported outcomes (PROs) compared with ADT plus placebos among patients with metastatic castration-naive prostate cancer, according to research published in The Lancet Oncology.1

While effective, ADT is associated with a number of health-related quality of life (HRQoL) issues and usually leads to castration-resistant disease within about a year of treatment initiation. While adding docetaxel to ADT can improve overall survival (OS) and progression-free survival (PFS), chemotherapy increases toxicity, and is not recommended for frail patients.

The ongoing phase 3 LATITUDE (ClinicalTrials.gov Identifier: NCT01715285) showed that — compared with ADT plus placebos — abiraterone acetate, prednisone, and ADT improve a number of outcomes in this patient population, including PFS, OS, and time to chemotherapy initiation. Whether this combination improves PROs and HRQoL was previously unknown.

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Patients enrolled in LATITUDE between February 2013 and December 2014 were randomly assigned to the abiraterone group (597 patients) or to the ADT-only group (602 patients). Patients completed the following questionnaires by electronic device at pre-established time points: the Brief Pain Inventory — Short Form (BPI-SF), Brief Fatigue Inventory (BFI), Functional Assessment of Cancer Therapy Prostate scale (FACT-P), and the EuroQol (EQ-5D-5L).

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Compliance was 90% or higher. After a median follow-up of 30.9 months, median time to worst pain intensity progression by BPI-SF and median time to worst fatigue intensity were not reached in either group. Patients in the 25th percentile of the abiraterone group, however, had a longer median time to worst pain intensity progression (11.07 months) and to worst fatigue intensity (18.4 months) than did those in the 25th percentile of the ADT-only group (5.62 months and 6.5 months, respectively).

Time to deterioration of functional status was also longer in the abiraterone group (median, 12.9 months) than in the ADT-only group (median, 8.3 months; hazard ratio, 0.85; P = .032).

The authors concluded that “treatment with ADT plus abiraterone acetate and prednisone could be considered a new option for standard of care for patients with metastatic castration-naive prostate cancer.”


  1. Chi KN, Protheroe A, Rodríguez-Antolín A, et al. Patient-reported outcomes following abiraterone acetate plus prednisone added to androgen deprivation therapy in patients with newly diagnosed metastatic castration-naive prostate cancer (LATITUDE): an international, randomised phase 3 trial. Lancet Oncol. 2018 Jan 8. doi: 10.1016/S1470-2045(17)30911-7 [Epub ahead of print]