TREATMENT OF PROSTATE CANCER

Treatment of Prostate Cancer

Treatment of Prostate Cancer

Introduction

The abiraterone acetate (marketed in France under the name of the laboratory Zytiga ® Janssen) is a novel selective inhibitor of the biosynthesis of androgens indicated for the treatment of cancer metastatic prostate cancer resistant to castration in adult males with the disease has progressed during or after chemotherapy containing docetaxel. It is continuously administered orally as a single dose per day, between meals, at a dose of 1000 mg daily or 4 tablets, in combination with prednisone or prednisolone at a dose of 5 mg twice per day. The abiraterone acetate obtained a favorable opinion from the CHMP (Committee for Medical Products for Human Use) July 21, 2011 after an accelerated assessment procedure and received his MA (Authorisation on the Market) September 7, 2011. Currently the product is not available in pharmacies, because not even on the list of reimbursable drugs. Our deep concern in this treatment modality is the treatment of prostate cancer, prominently by abiraterone. For efficient nursing, the nurse must understand the nature of this cancer and its legal solution abiraterone.

Discussion

History

The molecule of abiraterone acetate was initially discovered in 1990 in a research center in London (Institute of Cancer Research) by Dr. Gerry Potter. The patent was filed in 1994 by British Technology Group (BTG plc). BTG then granted the license of the molecule to the company Cougar Biotechnology in 2004 which then initiated the commercial development of the product. In 2009, the company Cougar Biotechnology was acquired by the company Johnson & Johnson, Janssen Pharmaceutical entity which is conducting the clinical trials and commercialization of the product.

Mechanism of Action

The abiraterone acetate is the only inhibitor of androgen biosynthesis available on the market that specifically targets CYP17A1. This molecule inhibits the activity of the enzyme complex a-hydroxylase/C17-20-lyase 17 (CYP17) allows one hand blocking the biosynthesis of adrenal and testicular androgens, acting on the component extratumorale of this synthesis, and other hand, a blocking androgen biosynthesis in the tumor cell itself, thus acting also on the intratumoral component. This new mechanism of action is fundamental since today studies show that the prostate cancer metastatic castration-resistant remains hormone sensitive, tumor synthesizing androgens it needs to stimulate its own growth.

Pharmacokinetics

The abiraterone acetate is rapidly converted in vivo to abiraterone, an inhibitor of androgen biosynthesis. The maximum plasma concentration of abiraterone acetate is reached about 2 hours after oral administration to fasting. Compared to the fasted state, administration of abiraterone acetate with food causes an increase in mean systemic exposure to abiraterone up to 10 times for area under the curve and up to 17 times for the maximum concentration depending on the fat content of food. Due to the normal variability of the content and composition of meals, taking this medicine with meals can cause widely varying levels of exposure. Thus, abiraterone acetate should not be taken with food. It should be taken at least two hours after eating and no food should be eaten for at least one ...