Real-world outcomes of abiraterone in metastatic castration-sensitive andcastration-resistant prostate cancer at a referral center in southern Peru

Abstract

Introduction. Metastatic prostate cancer (mPCa) remains a major clinical challenge in Latin America, where access to innovative systemic therapies is often limited. Abiraterone acetate has demonstrated significant efficacy in pivotal clinical trials in both metastatic castration-sensitive prostate cancer (mCSPC) and metastatic castration-resistant prostate cancer (mCRPC). The present study aims to describe real-world outcomes associated with abiraterone treatment at a tertiary referral center in southern Peru. Materials and Methods. We conducted a retrospective observational study including patients with mPCa treated with abiraterone. Baseline clinical characteristics were collected, including age at diagnosis, prostate-specific antigen (PSA) levels, comorbidities, type of concomitant androgen deprivation therapy, and sites of metastasis. Clinical outcomes evaluated were radiographic progression-free survival (rPFS) and overall survival (OS). Results. Of the study population, 38.8% had mCSPC and 61.2% had mCRPC. In the mCSPC cohort, the mean age was 71.7 years and the median baseline PSA was 194.7 ng/mL, whereas in the mCRPC cohort, the mean age was 70.9 years with a median PSA of 672 ng/mL. Median rPFS was not reached in the mCSPC group, while it was 16.5 months in the mCRPC group (p = 0.006). Among patients with mCRPC, median rPFS was 22.2 months in those treated with abiraterone prior to docetaxel and 16.3 months in those previously exposed to docetaxel (p = 0.167). Median OS was not reached in any subgroup at the time of analysis. Conclusion. These real-world data suggest that abiraterone provides clinically meaningful effectiveness in patients with mPCa treated in southern Peru, with outcomes broadly consistent with those reported in pivotal clinical trials, particularly when administered in earlier disease settings.