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Abiraterone acetate withdrawal syndrome: Speculations on the underlying mechanisms
- Source :
- Oncology Letters.
- Publication Year :
- 2017
- Publisher :
- Spandidos Publications, 2017.
-
Abstract
- A 72-year-old man initially presented with lumbar and right chest pain, but was later found out to also have an elevated prostate-specific antigen (PSA) level at 2,000.0 ng/ml. Further evaluation disclosed metastatic prostate cancer involving the bones and lymph nodes. The patient was initially treated with combined androgen blockade (CAB) with leuprolide acetate and bicalutamide. After 6 months of CAB, the patient's PSA level began to rise from the nadir (85.1 ng/ml) to 113.3 ng/ml. Bicalutamide was withdrawn in anticipation of anti-androgen withdrawal syndrome and the PSA level declined temporally. However, it increased up to 517.0 ng/ml thereafter. Consequently, a year after CAB, abiraterone acetate (AA) was initiated at a standard dose of 1,000 mg daily in combination with 10 mg of prednisolone. PSA rapidly decreased to the nadir of 20.1 ng/ml thereafter. The PSA level remained stable until 2 years after AA administration. However, he decided to reduce the dose of AA to half of the standard dose (500 mg daily). Contrary to our expectations, the serum PSA level promptly decreased to a nadir of 8.1 ng/ml. Thereafter, the PSA level remained stable until 3 years and 9 months after AA administration. Subsequently, the patient stopped taking AA and prednisolone. However, to our surprise, the patient's serum PSA level decreased further to
- Subjects :
- Cancer Research
medicine.medical_specialty
Bicalutamide
medicine.drug_class
030232 urology & nephrology
Urology
urologic and male genital diseases
03 medical and health sciences
chemistry.chemical_compound
Prostate cancer
0302 clinical medicine
medicine
business.industry
Abiraterone acetate
Articles
Androgen
medicine.disease
Discontinuation
Blockade
Oncology
chemistry
030220 oncology & carcinogenesis
Prednisolone
Lymph
business
medicine.drug
Subjects
Details
- ISSN :
- 17921082 and 17921074
- Database :
- OpenAIRE
- Journal :
- Oncology Letters
- Accession number :
- edsair.doi.dedup.....5e46b86d319580d9096d3eb70d063709