A 74-Year-Old Man with Metastatic Castration-Resistant Prostate Cancer (mCRPC) and A 62-Year-Old Man with High-Risk Localized Prostate Cancer

A panelist discusses how a man aged 74 years with mCRPC who progressed on enzalutamide was successfully treated with abiraterone, highlighting the importance of selecting the appropriate formulation based on patient adherence and lifestyle factors.

A panelist discusses how adherence considerations are crucial when selecting between different abiraterone formulations, emphasizing that the microformulation offers flexibility by allowing administration with or without food compared with the traditional fasting requirements.

A panelist discusses how food significantly affects abiraterone absorption, particularly fatty meals, which can increase absorption to dangerous levels, making the microformulation advantageous by eliminating fasting concerns.

A panelist discusses how patient comorbidities like diabetes and liver disease influence abiraterone formulation selection, noting that some physicians worry about steroid effects on blood glucose and the importance of monitoring liver function.

A panelist discusses how a 62-year-old man with high-risk localized prostate cancer was treated with intensified therapy, including abiraterone plus radiation, but experienced tolerability issues with the traditional fasting formulation.

A panelist discusses how genomic classifiers play a crucial role in determining whether treatment intensification with agents like abiraterone is beneficial for patients with high-risk localized prostate cancer.

A panelist discusses how, for high-risk localized prostate cancer with questionable lymph node involvement, radiation therapy combined with systemic treatment may be preferable to radical prostatectomy due to the ability to treat a wider field of potential microscopic disease.

A panelist discusses how patients having difficulty with traditional abiraterone fasting requirements can be switched to microsized abiraterone (taken with food) or off-label low-dose abiraterone with low-fat breakfast, though adherence to dietary restrictions remains challenging.

A panelist discusses how the choice between microformulation abiraterone and off-label low-dose regimens is often dictated by cost and insurance coverage rather than purely clinical considerations.

A panelist discusses how different abiraterone formulations require specific steroid combinations—prednisone with traditional abiraterone and prednisolone with microformulation—and the importance of following labeling recommendations.

A panelist discusses how patients with high-risk localized prostate cancer receiving treatment intensification should complete an 18- to 24-month course of systemic therapy with radiation for optimal cure rates, rather than stopping early due to prostate-specific antigen (PSA) response alone.