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Abiraterone is a pill that shuts down testosterone production everywhere, including inside the tumour. Discovered at the Institute of Cancer Research, now generic and used from the first metastatic diagnosis.
Abiraterone acetate irreversibly inhibits CYP17A1 (17-alpha-hydroxylase and 17,20-lyase), shutting down androgen synthesis in the adrenal glands and inside the tumour, not just the testes; it is given with prednisone to offset mineralocorticoid excess. Its evidence spans advanced prostate cancer: COU-AA-301 and 302 (mCRPC post- and pre-docetaxel), LATITUDE and STAMPEDE (mHSPC, overall survival benefit; LATITUDE OS 53.3 versus 36.5 months, HR 0.66) and PEACE-1 (triplet with docetaxel). Generic since 2018 to 2019, it is the backbone partner for PARP inhibitors (PROpel, MAGNITUDE), capivasertib (CAPItello-281) and Pluvicto (PSMAddition). Open questions are how to choose between abiraterone and the AR antagonists, and which men need a third drug. Discovered at the Institute of Cancer Research, it is the affordable hormone pill most men with metastatic prostate cancer now start at diagnosis.
Irreversible CYP17A1 (17α-hydroxylase/17,20-lyase) inhibition blocks adrenal and intratumoural androgen synthesis. Connects to Androgen receptor.
1.Abiraterone acetate acts on Androgen receptor, the hormone receptor or the enzyme that makes the hormone.
Oral, self-administered, so it is a Part D drug: covered through a stand-alone Part D plan or Medicare Advantage drug benefit, usually on the specialty tier with 25 to 33% coinsurance until the annual cap ($2,000 in 2025, $2,100 in 2026). Generic abiraterone (since 2018) is inexpensive; the Yonsa formulation and brand Zytiga cost far more.
Multi-source generic on low-cost tiers; usually no prior authorisation. Cash prices without insurance are modest. Many plans require generic abiraterone before enzalutamide or other novel hormonal agents.
Sources: Medicare.gov: Drug coverage (Part D) · Medicare.gov: Costs for Medicare drug coverage (annual out-of-pocket cap). Not medical or financial advice; verify with your plan.
Sources: NICE TA259 · SMC advice: abiraterone. Funding decisions are indication-specific and change monthly; verify with NICE and your treating team.
Capivasertib approved for use with abiraterone and prednisone in PTEN-deficient metastatic prostate cancer (CAPItello-281); abiraterone itself was already approved source
| Region | Year | Indication |
|---|---|---|
| US | 2011 | mCRPC after docetaxel |
| US | 2012 | mCRPC pre-chemotherapy |
| US | 2018 | High-risk mHSPC (LATITUDE) |
Read for the class this product belongs to (androgen deprivation) unless the answer names the product. Population figures from the cohorts named, not a prediction for one person. Blank where no source gives a recovery figure.
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The randomised proof for PARP inhibition in BRCA-altered prostate cancer, and the clearest evidence that the homologous recombination repair gene list should not be used as a single yes-or-no test. ATM-altered disease needs a different answer, and does not yet have one.
Two years of abiraterone with androgen deprivation and radiotherapy is the standard for very high-risk and node-positive localised prostate cancer.
It is the prospective test of the PI3K and androgen receptor feedback hypothesis in men, and it shows both halves of the answer: the biomarker-selected population benefits, and the benefit is small enough that the toxicity has to be weighed honestly.
The first randomised evidence that the order in which prostate cancer treatments are given changes how long they work, independently of which treatments they are. It is also a rare trial in which quality of life pointed one way and the primary endpoint pointed nowhere.
It shows that the useful information in a castration-resistant plasma sample is in the repair genes and TP53 rather than in the androgen receptor finding that dominates the report, and it is the closest thing the field has to a head-to-head comparison of abiraterone against enzalutamide.
It made PTEN a protein test rather than a genomic one in this disease, and the concordance between early and late biopsies is the practical point: the diagnostic block usually answers the question, so a fresh biopsy is not needed to make this call.
The first predictive resistance biomarker in prostate cancer, and a mechanism rather than a correlation: a receptor with no ligand-binding domain cannot be blocked by a drug that binds the ligand-binding domain. It is also the origin of the case for androgen receptor degraders, which destroy the protein rather than blocking a site the protein no longer has.
One of the most cited trial reports Europe PMC returns for Abiraterone acetate in Prostate cancer, so it is a natural first reading for anyone weighing the idea it is linked from. The record was linked automatically by title and abstract; read the abstract above and the paper itself before relying on any figure.
Query for this drug: (TITLE:"Abiraterone acetate" OR ABSTRACT:"Abiraterone acetate" OR TITLE:"Zytiga" OR ABSTRACT:"Zytiga" OR TITLE:"generic" OR ABSTRACT:"generic" OR TITLE:"Abiraterone" OR ABSTRACT:"Abiraterone") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Abiraterone acetate, not a curated reading list.
Shares An Open-label Study of JSB462 (Luxdegalutamide) in Combination With Abiraterone in Adult Male Patients With Metastatic Hormone-sensitive Prostate Canc, A Clinical Study of QLC5508 and/or QLH12016 in Combination With Other Anti-tumor Therapies in Subjects With Advanced Prostate Cancer, A Phase Ib/II Open-label Study of AMO959 With Lutetium (177Lu) Vipivotide Tetraxetan (AAA617) in Combination With ARPI in Adult Participants With PSMA, A Study for Subjects With Prostate Cancer Who Previously Participated in an Enzalutamide Clinical Study.
Shares Conventional Androgen Deprivation Therapy (ADT) With or Without Abiraterone Acetate + Prednisone and Apalutamide Following a Detectable PSA After Radiation and ADT, Abiraterone, Enzalutamide, or Apalutamide in Castrate-sensitive Prostate Cancer., Study of AZD5305 When Given in Combination With New Hormonal Agents in Patients With Metastatic Prostate Cancer, An Efficacy and Safety Study of Apalutamide (JNJ-56021927) in Combination With Abiraterone Acetate and Prednisone Versus Abiraterone Acetate and Prednisone in Participants With Chemotherapy-naive Metastatic Castration-resistant Prostate Cancer (mCRPC).
Shares COU-AA-302, ERA 223, PTEN protein loss and clinical outcome from castration-resistant prostate cancer treated with abiraterone acetate, Prostate Cancer Foundation (PCF).
Shares TulmiSTAR-02: A Phase I/II Open-label Study of Tulmimetostat in Combination With Darolutamide vs. Darolutamide, and Tulmimetostat With Abiraterone in , Study of AZD5305 When Given in Combination With New Hormonal Agents in Patients With Metastatic Prostate Cancer, AZD2265 Compared With Standard of Care in PSMA-positive Metastatic Castration-resistant Prostate Cancer (VECTRA-01), Disease volume (CHAARTED high-volume versus low-volume) and LATITUDE risk.
Shares Nicholas James, Johann de Bono, The Institute of Cancer Research, The Royal Marsden.
Shares Paul Workman, CAPItello-281, Chemical carcinogenesis - receptor activation, PTEN alteration (sequencing) and PTEN loss (IHC).
Shares LATITUDE, Androgen receptor pathway inhibitor (ARPI), mCRPC and mHSPC (castration-resistant vs hormone-sensitive prostate cancer), STAMPEDE.
Shares Abiraterone in metastatic prostate cancer without previous chemotherapy, TRANSFORMER: bipolar androgen therapy versus enzalutamide in asymptomatic metastatic castration-resistant prostate cancer, TRITON3: rucaparib or physician's choice in metastatic castration-resistant prostate cancer, AR-V7 and resistance to enzalutamide and abiraterone in prostate cancer.