Una sola tableta de Abiraterona con comida en vez de 4 tabletas en ayuno para pacientes con cáncer de próstata metastásico resistente a la castración: perspectivas fármaco-económicas en un país en desarrollo / One Pill of Abiraterone with Food Instead of Four Pills in Fasting State for Metastatic Castration Resistant Prostate Cancer Patients: Pharmaco-economic Perspectives in a Developing Country

Recientemente se publicó en el Journal of Clinical Oncology un estudio prospectivo aleatorizado fase II, que comparó dosis bajas de Abiraterona (250mg) administrada con comida vs la dosis estándar de dicho medicamento (1000mg), en pacientes con cáncer de próstata metastásico resistente a la castración (mCRPC)1 y concluyó que la dosis baja no es inferior a la dosis estándar en cuanto a la respuesta de PSA y a la supervivencia libre de progresión (PFS).

A prospective randomized phase II study comparing low dose Abiraterone (250 mg) administered with food versus the standard dose (1000 mg) in metastatic castration resistant prostate cancer, was recently published in The Journal of Clinical Oncology. It concluded that the low dose was non-inferior compared to the standard dose for the endpoints prostate specific antigen (PSA) response and progression free survival (PFS).

Clinical and pathologic factors predicting reclassification in active surveillance cohorts

ABSTRACT The incidence of small, lower risk well-differentiated prostate cancer is increasing and almost half of the patients with this diagnosis are candidates for initial conservative management in an attempt to avoid overtreatment and morbidity associated with surgery or radiation. A proportion of patients labeled as low risk, candidates for Active Surveillance (AS), harbor aggressive disease and would benefit from definitive treatment. The focus of this review is to identify clinicopathologic features that may help identify these less optimal AS candidates. A systematic Medline/PubMed Review was performed in January 2017 according to PRISMA guidelines; 83 articles were selected for full text review according to their relevance and after applying limits described. For patients meeting AS criteria including Gleason Score 6, several factors can assist in predicting those patients that are at higher risk for reclassification including higher PSA density, bilateral cancer, African American race, small prostate volume and low testosterone. Nomograms combining these features improve risk stratification. Clinical and pathologic features provide a significant amount of information for risk stratification (>70%) for patients considering active surveillance. Higher risk patient subgroups can benefit from further evaluation or consideration of treatment. Recommendations will continue to evolve as data from longer term AS cohorts matures.