Real-World Outcomes of Upfront Abiraterone in Metastatic Castration-Sensitive Prostate Cancer Patients at a Tertiary Care Hospital.

Background  Metastatic castration-sensitive prostate cancer is defined as prostate cancer with de novo metastatic disease that responds to androgen deprivation therapy by keeping the testosterone levels low. Endogenous androgen synthesis is further blocked by abiraterone acetate along with prednisolone and indicated in patients with metastatic castration-sensitive prostate cancer. However, over time, these patients will become castration-resistant. The time from castration-sensitive to castration-resistant in our population is short, which calls for further investigation on a larger scale to explore factors such as genetics and environmental influences that may play a significant role.  Methodology  This retrospective study involved 47 adult patients aged 40 years and older. It focused exclusively on patients who were presented with de novo metastatic castration-sensitive disease and were treated with upfront abiraterone acetate. The study was carried out at the Department of Medical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan. Patient data spanning 10 years, from 2014 to 2024, was collected from hospital records. Results  The cohort demonstrated a median progression-free survival (PFS) of 20.7 months and a median overall survival (OS) of 38.4 months. These outcomes represent the entire study population, irrespective of subgroup classification. Different subgroup analyses do not show any statistically significant difference.  Conclusion  In our study, OS and PFS were lower than those reported in landmark studies conducted on similar populations in Western countries. This disparity highlights the need for further research in subcontinental populations to investigate potential contributing factors, including environmental influences or genetic variations.