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Abiraterone plus androgen deprivation therapy (ADT) is a combination regimen used primarily in the treatment of prostate cancer, especially metastatic castration-sensitive or high-risk non-metastatic prostate cancer. Abiraterone acetate is an oral small molecule inhibitor of CYP17 (steroid 17α-hydroxylase/17,20-lyase), a key enzyme in androgen biosynthesis. By inhibiting CYP17, abiraterone suppresses the production of androgens not only from the testes but also from adrenal glands and within tumor tissue itself. ADT refers to therapies that reduce circulating testosterone levels—typically through GnRH agonists/antagonists or orchiectomy—thereby depriving prostate cancer cells of their primary growth signal via the androgen receptor. The combination has been shown in multiple large randomized trials (e.g., STAMPEDE, LATITUDE) to significantly improve overall survival and progression-free survival compared to ADT alone for men with newly diagnosed metastatic or high-risk non-metastatic prostate cancer[1][2][5][8]. The addition of prednisone is standard with abiraterone to mitigate mineralocorticoid excess side effects. Common adverse effects include hypertension, hypokalemia, fluid retention (from mineralocorticoid excess), liver function abnormalities (from abiraterone), as well as sexual dysfunction, hot flashes, fatigue, osteoporosis risk and metabolic changes associated with long-term hormone suppression from ADT[7][10]. The risk for grade III–V adverse events is higher than with ADT alone[1].
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