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abiraterone

abiraterone

Overview

Abiraterone is a hormonal therapy used in the treatment of prostate cancer. It acts by inhibiting CYP17A1, a key enzyme in androgen biosynthesis, thereby reducing androgen production from the testes, adrenal glands, and within the tumor microenvironment. Because many prostate cancers depend on androgen receptor signaling for growth and survival, abiraterone is used to suppress this pathway and slow disease progression.

Clinically, abiraterone is most closely associated with advanced prostate cancer, including metastatic castration-sensitive prostate cancer and metastatic castration-resistant prostate cancer. It is commonly studied and used in combination with androgen deprivation therapy and, in some settings, with other agents such as enzalutamide, olaparib, cabazitaxel, and carboplatin. Recent research has also examined how tumor biology, including androgen receptor pathway alterations and circulating tumor DNA profiles, may influence sensitivity to abiraterone-based treatment.

Focus of Latest Publications

Recent publications have focused on abiraterone as a backbone androgen receptor pathway inhibitor in metastatic prostate cancer, with studies examining whether outcomes can be improved by adding metastasis-directed radiotherapy, combination targeted therapy, chemotherapy, or other androgen receptor-directed agents. Across these reports, abiraterone was evaluated in both castration-resistant and castration-sensitive settings, reflecting its continued role in advanced disease and in treatment intensification strategies.

In oligometastatic castrate-resistant prostate cancer, the ARTO trial assessed stereotactic body radiotherapy (SBRT) added to abiraterone acetate plus androgen deprivation therapy (ADT). The original trial had shown improved early clinical outcomes with metastasis-directed therapy, and the recent analysis was designed to examine the long-term impact of SBRT on overall survival. Another study explored a different intensification approach in high-volume metastatic castration-sensitive prostate cancer, using cabazitaxel and carboplatin followed by abiraterone plus ADT in the single-arm CASCARA phase II trial, which evaluated safety and efficacy of this sequential regimen.

Combination strategies with targeted agents have also been investigated. A phase II trial evaluated olaparib plus abiraterone in metastatic hormone-sensitive prostate cancer with homologous recombination repair gene mutations, building on prior evidence that olaparib combined with abiraterone and prednisone can prolong radiographic progression-free survival in metastatic castration-resistant disease. In metastatic prostate cancer with PSA progression on abiraterone, a phase 1b study tested bavdegalutamide (ARV-110), an oral PROTAC androgen receptor degrader, in combination with abiraterone to assess safety, tolerability, and pharmacokinetics.

Other recent work has examined biological correlates of response to abiraterone. One study reported that metastatic prostate cancers with high proliferation rates may show greater sensitivity to androgen receptor pathway inhibition, including abiraterone. Another analysis of longitudinal ctDNA from patients treated in the Alliance A031201 trial noted that androgen receptor pathway inhibitors such as abiraterone and enzalutamide are standard therapies for metastatic castration-resistant prostate cancer, while also highlighting the frequent emergence of primary and secondary resistance and the need to define genomic features associated with that resistance.

Key Publications

  • NEWJul SBRT plus abiraterone acetate and ADT versus abiraterone acetate and ADT in oligometastatic castrate-resistant prostate cancer (ARTO): long-term, unplanned overall survival analysis of an open-label, randomised, phase 2 trial. (The Lancet. Oncology, 2026, PMID 42372744): "The ARTO trial showed improved early clinical outcomes by adding metastasis-directed therapy (MDT), through stereotactic body radiotherapy (SBRT), to abiraterone acetate and ADT in oligometastatic castrate-resistant prostate cancer."
  • Jun Phase 1b trial of Bavdegalutamide (ARV-110) in combination with Abiraterone for metastatic prostate cancer. (Clinical cancer research : an official journal of the American Association for Cancer Research, 2026, PMID 42227954): "This phase 1b clinical trial evaluated safety/tolerability and pharmacokinetics of bavdegalutamide, an oral PROteolysis TArgeting Chimera (PROTAC) androgen receptor (AR) degrader, combined with abiraterone in patients with mPC experiencing prostate-specific antigen (PSA) progression on abiraterone."
  • May Olaparib combined with abiraterone in HRR-mutated metastatic hormone-sensitive prostate cancer: a single-arm phase II trial. (World journal of urology, 2026, PMID 42115448): "Although olaparib plus abiraterone and prednisone has significantly prolonged radiographic progression-free survival (rPFS) in metastatic castration resistant prostate cancer patients (mCRPC), little is known about the effects of this combination therapy on metastatic hormone-sensitive prostate cancer (mHSPC), especially for those with homologous recombination repair (HRR) genes."
  • May Tumor proliferation associates with greater sensitivity to androgen receptor pathway inhibition in metastatic prostate cancer. (The Journal of clinical investigation, 2026, PMID 41915426): "there is increased sensitivity to hormone therapy with abiraterone."
  • Jun Carboplatin, Cabazitaxel, and Abiraterone in High-Volume Metastatic Castration-Sensitive Prostate Cancer: The CASCARA Phase II Study. (Clinical cancer research : an official journal of the American Association for Cancer Research, 2026, PMID 41880596): "This multicenter, single-arm, phase II trial evaluated the safety and efficacy of cabazitaxel and carboplatin followed by abiraterone, plus androgen deprivation therapy (ADT), in patients with high-volume metastatic castration-sensitive prostate cancer (mCSPC)."
  • Jun Evolution of AR and Non-AR Alterations in ctDNA of Patients with Metastatic Prostate Cancer Treated in the Phase III Alliance A031201 Trial. (Clinical cancer research : an official journal of the American Association for Cancer Research, 2026, PMID 41587107): "Androgen receptor pathway inhibitors (ARPI), such as enzalutamide and abiraterone, are standard treatments for metastatic castration-resistant prostate cancer (mCRPC)."
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