A Better Dosing Regimen for a Widely Prescribed Prostate Cancer Drug?

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Taking a widely prescribed prostate cancer drug with a low-fat meal instead of on an empty stomach-the usual recommendation-can allow men to use a lower dose with no loss in effectiveness, a 2018 study in the Journal of Clinical Oncology finds.

Abiraterone (Zytiga) is approved for the treatment of metastatic castration-resistant prostate cancer (M-CRPC), meaning cancer that has spread beyond the prostate and no longer responds to androgen deprivation therapy. The approved dose is 1,000 mg daily, with no food consumed for at least two hours before, or for an hour after, taking it.

Some studies had shown that taking abiraterone with food significantly increased concentrations of the drug in the body. With that in mind, researchers randomly assigned 68 men with M-CRPC to take 250 mg of abiraterone daily along with a low-fat breakfast or to take the usual dose on an empty stomach at least two hours before breakfast.

At 12 weeks, the low dose of abiraterone taken with food was slightly more effective than the higher-dose empty-stomach regimen, as measured by decreases in PSA levels. Moreover, both doses staved off progression of cancer the same length of time, roughly nine months.

Abiraterone costs about $10,000 a month, and many men take it for several years. A lower dose taken with food could mean smaller co-payments and more convenience for the men who take it. Researchers continue to study the optimal regimen for this important drug.