Abiraterone Acetate for Treatment of Metastatic Castration-resistant Prostate Cancer in Chemotherapy-naive Patients. An Italian Analysis of Patients' Satisfaction

This article highlights the possible role of “patient-reported outcomes” in the evaluation of a new therapy. Abiraterone acetate is a novel treatment for metastatic prostate cancer characterized by good safety and oncologic efficacy. Few studies have investigated patients' satisfaction with treatment. Our data show that abiraterone acetate is associated with good satisfaction with treatment and that patient's satisfaction can be a predictor of good oncologic outcomes. Introduction Abiraterone acetate (AA) gives a significant improvement in survival for patients with metastatic castration-resistant prostate cancer (mCRPC) before and after chemotherapy and has a favorable effect on patients' health-related quality of life and pain. Only a few studies have investigated patient-reported outcomes (PROs) in AA treatment for mCRPC. The aim of this study was to investigate patients' satisfaction in men affected by mCRPC treated with AA. Materials and Methods This was a retrospective analysis of a database of consecutive chemonaive patients with progressive mCRPC. Patients were treated with AA until disease progression, death, or unacceptable toxicity. Evaluation was performed at baseline and every 4 weeks by means of physical examination and laboratory studies. Eastern Cooperative Oncology Group score, pain symptoms, treatment-related toxicity, prostate-specific antigen (PSA), and overall and progression-free survival were recorded. Satisfaction with treatment was investigated at 6 months by means of a 4-point arbitrary scale. Results One-hundred twenty-eight patients were enrolled. Patients' satisfaction with treatment was “greatly improved” in 36.1% of patients and “improved” in 32.4% of them. Patients with higher satisfaction had lower baseline and final PSA values (P < .05), lower PSA levels at 12 weeks (P = .080), and less pain symptoms and lower Brief Pain Inventory scores (P = .001). Satisfaction with treatment was significantly correlated with baseline PSA level (P = .018), presence of pain (P = .007), duration of androgen deprivation therapy >12 months (P = .025), and number of hormonal manipulations (P = .051). Progression-free survival significantly correlated with patient satisfaction (P < .001). Conclusion AA is safe and well tolerated in chemonaive mCRPC patients, ensures good oncological and PROs. Patient's satisfaction is a predictor of progression-free survival.