Abiraterone acetate
Abiraterone is a pill that shuts down testosterone production everywhere, including inside the tumour. Discovered at the Institute of Cancer Research, now generic and used from the first metastatic diagnosis.
Overview
Abiraterone acetate irreversibly inhibits CYP17A1 (17-alpha-hydroxylase and 17,20-lyase), shutting down androgen synthesis in the adrenal glands and inside the tumour, not just the testes; it is given with prednisone to offset mineralocorticoid excess. Its evidence spans advanced prostate cancer: COU-AA-301 and 302 (mCRPC post- and pre-docetaxel), LATITUDE and STAMPEDE (mHSPC, overall survival benefit; LATITUDE OS 53.3 versus 36.5 months, HR 0.66) and PEACE-1 (triplet with docetaxel). Generic since 2018 to 2019, it is the backbone partner for PARP inhibitors (PROpel, MAGNITUDE), capivasertib (CAPItello-281) and Pluvicto (PSMAddition). Open questions are how to choose between abiraterone and the AR antagonists, and which men need a third drug. Discovered at the Institute of Cancer Research, it is the affordable hormone pill most men with metastatic prostate cancer now start at diagnosis.
1.Abiraterone acetate acts on its target, the hormone receptor or the enzyme that makes the hormone.
- Medicare
- Part D (self-administered)
Oral, self-administered, so it is a Part D drug: covered through a stand-alone Part D plan or Medicare Advantage drug benefit, usually on the specialty tier with 25 to 33% coinsurance until the annual cap ($2,000 in 2025, $2,100 in 2026). Generic abiraterone (since 2018) is inexpensive; the Yonsa formulation and brand Zytiga cost far more.
- Commercial insurance
- covered on label
Multi-source generic on low-cost tiers; usually no prior authorisation. Cash prices without insurance are modest. Many plans require generic abiraterone before enzalutamide or other novel hormonal agents.
- Assistance programmes
- PAN Foundation: Disease-specific co-pay and premium funds; open and closed funds change monthly.
- HealthWell Foundation
- CancerCare Co-Payment Assistance Foundation
- Patient Advocate Foundation Co-Pay Relief
Sources: Medicare.gov: Drug coverage (Part D) · Medicare.gov: Costs for Medicare drug coverage (annual out-of-pocket cap). Not medical or financial advice; verify with your plan.
- Appraised for
- Metastatic castration-resistant prostate cancer after docetaxel
- Notes
- Before chemotherapy: TA387 (2016). Newly diagnosed high-risk hormone-sensitive disease (STAMPEDE/LATITUDE) was not recommended in TA721 (2021), but abiraterone went generic in 2022 and NHS England commissioned it for mHSPC via national policy.
- NHS England
- Routinely funded for the appraised indication (or via managed access)
Sources: NICE TA259 · SMC advice: abiraterone. Funding decisions are indication-specific and change monthly; verify with NICE and your treating team.
Approvals
| Region | Year | Indication |
|---|---|---|
| US | 2011 | mCRPC after docetaxel |
| US | 2012 | mCRPC pre-chemotherapy |
| US | 2018 | High-risk mHSPC (LATITUDE) |
Trials
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Landmark trials
Latest papers
topQuery for this drug: (TITLE:"Abiraterone acetate" OR ABSTRACT:"Abiraterone acetate" OR TITLE:"Zytiga" OR ABSTRACT:"Zytiga" OR TITLE:"generic" OR ABSTRACT:"generic") AND (radiopharmaceutical OR radioligand OR radionuclide OR theranostic OR "nuclear medicine" OR "molecular imaging" OR radiotracer OR scintigraphy OR cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Abiraterone acetate, not a curated reading list.
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