Addition of abiraterone to ADT/docetaxel does not increase bone loss

Bone mineral density decreases over time in men with de novo metastatic hormone-sensitive prostate cancer (mHSPC) treated with androgen deprivation therapy (ADT) plus docetaxel. The addition of abiraterone to ADT/docetaxel does not augment this decrease.

Both ADT and next-generation hormone therapies are associated with bone loss and fracture [1]. Addition of abiraterone plus prednisone (AAP) to ADT with or without docetaxel improved overall survival in men with de novo mHSPC in the phase 3 PEACE-1 trial (NCT01957436) [2]. Dr Guilhem Roubaud (Institut Bergonié, France) presented an analysis of bone mineral density (BMD), which was planned by an amendment in the last randomised patients (n=210) to assess whether the addition of AAP increases bone loss [3].

BMD of the lumbar spine, femoral neck, and total hip were measured by dual x-ray absorptiometry at baseline, and after 6, 12, and 24 months of treatment in both study arms. The mean percentage change in BMD values were calculated from baseline to the different time points. Among the 195 participants with baseline BMD data, 97 were treated with AAP and 98 without. T-scores for both lumbar spine, femoral neck, and total hip in all patients decreased over time but did not significantly differ between arms from baseline until 24 months follow-up.

Therefore, Dr Roubaud concluded that adding AAP to ADT/docetaxel was associated with no significant increase in bone loss over the first 2 years. However, BMD should be carefully assessed in patients with mHSPC, and bone-resorptive agents are indicated for treatment-induced bone loss.

1. Hussain A, et al. Prostate Cancer Prostaic Dis. 2021;24:290–300.
2. Fizazi K, et al. Ann Oncol 2021;32(suppl5):S1299.
3. Roubaud G, et al. Bone mineral density in men with de novo metastatic castration-sensitive prostate cancer treated with or without abiraterone plus prednisone in the PEACE-1 phase 3 trial. Abstract 19, ASCO GU 2022, 17–19 February.

 

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Posted on 8 April 202217 May 2024