Rx Prolongs Life...Without Pain

Prostate cancer pain delayed with abiraterone acetate

/ Author:  / Reviewed by: Robert Carlson, M.D Beth Bolt, RPh

(RxWiki News) When cancer advances, the pain can be intense. A recently approved medicine may offer relief from both disease progression and pain.

Zytiga (abiraterone acetate) was found in a new study to delay the progression of pain in men with advanced prostate cancer when taken along with prednisone (sold under a variety of brand names).

Delaying the pain also delayed a decline in quality of life for these gentlemen.

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Ethan Basch, MD, director of the Cancer Outcomes Research Program at the University of North Carolina Lineberger Comprehensive Cancer Center, and colleagues from around the world conducted this study designed to measure the pain relief effects and quality of life impact of Zytiga.

“One of the most dreaded complications of castration-resistant prostate cancer is progressive pain,” E. David Crawford, MD, professor of surgery, urology and radiation oncology and head of the Section of Urologic Oncology at the University of Colorado Health Sciences Center in Denver, told dailyRx News.

Castration-resistant prostate cancer cannot be cured. And pain can be a major predictor of overall survival, according to Dr. Basch.

For this study, participants were enrolled from 151 facilities around the world and included 1,088 men with metastatic castration-resistant prostate cancer that had spread to other areas of the body.

The men were randomly assigned to receive either oral Zytiga plus prednisone or placebo (fake medication) plus prednisone in continuous four-week cycles.

Participants completed questionnaires that asked questions about pain levels and health-related quality of life issues.

Overall, the Zytiga plus prednisone group had significant delays in pain getting worse, which meant they enjoyed a higher quality of life for longer.

Study results also showed the following:

  • Average time of pain progression for the Zytiga group was 26.7 months, compared to 18.4 months for the placebo plus prednisone group.
  • Median time until pain interfered with daily activities was 10.3 months for the men receiving Zytiga versus 7.4 months for the men receiving prednisone alone.
  • Progression to worst pain was also longer in the Zytiga group — 26.7 months compared to 19.4 months in the placebo group.
  • The men receiving Zytiga also reported that health-related quality of life was not impacted by pain for 12.7 months, while those taking prednisone only said quality of life started to decline after 8.3 months.

Zytiga was approved by the US Food and Drug Administration (FDA) in 2011. The medication has been demonstrated to extend survival for about four months.

“Abiraterone acetate is one of seven new drugs approved for advanced prostate cancer in the past several years. This agent, which is known as an androgen biosynthesis inhibitor (ABI), further decreases testosterone of adrenal and tumor origin, improves survival and now delays pain progression,“ Dr. Crawford said.

This study was published September 24 in Lancet Oncology.

Janssen Research & Development funded the research.

A number of the study authors have financial relationships with Janssen and other pharmaceutical and research firms.

Review Date: 
September 30, 2013
Last Updated:
October 1, 2013