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Sarcopenia and change in body composition following maximal androgen suppression with abiraterone in men with castration-resistant prostate cancer

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Pezaro, C., Mukherji, D., Tunariu, N., Cassidy, A. M., Omlin, A., Bianchini, D., Seed, G., Reid, A. H. M., Olmos, D., de Bono, J. S., Attard, G. (2013) Sarcopenia and change in body composition following maximal androgen suppression with abiraterone in men with castration-resistant prostate cancer. BRITISH JOURNAL OF CANCER, 109 (2). pp. 325-331. ISSN 0007-0920

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Official URL: http://www.nature.com/bjc/journal/v109/n2/full/bjc...

Abstract

Background: Standard medical castration reduces muscle mass. We sought to characterize body composition changes in men undergoing maximal androgen suppression with and without exogenous gluocorticoids. Methods: Cross-sectional areas of total fat, visceral fat and muscle were measured on serial CT scans in a post-hoc analysis of patients treated in Phase I/II trials with abiraterone followed by abiraterone and dexamethasone 0.5mg daily. Linear mixed regression models were used to account for variations in time-on-treatment and baseline body mass index (BMI). Results: Fifty-five patients received a median of 7.5 months abiraterone followed by 5.4 months abiraterone and dexamethasone. Muscle loss was observed on single-agent abiraterone (maximal in patients with baseline BMI >30, -4.3%), but no further loss was observed after addition of dexamethasone. Loss of visceral fat was also observed on single-agent abiraterone, (baseline BMI >30 patients -19.6%). In contrast, addition of dexamethasone led to an increase in central visceral and total fat and BMI in all the patients. Interpretation: Maximal androgen suppression was associated with loss of muscle and visceral fat. Addition of low dose dexamethasone resulted in significant increases in visceral and total fat. These changes could have important quality-of-life implications for men treated with abiraterone.

Item Type: Article
Authors (ICR Faculty only): De Bono, Johann
All Authors: Pezaro, C., Mukherji, D., Tunariu, N., Cassidy, A. M., Omlin, A., Bianchini, D., Seed, G., Reid, A. H. M., Olmos, D., de Bono, J. S., Attard, G.
Additional Information: ISI Document Delivery No.: 189BQ Times Cited: 0 Cited Reference Count: 27 Pezaro, C. Mukherji, D. Tunariu, N. Cassidy, A. M. Omlin, A. Bianchini, D. Seed, G. Reid, A. H. M. Olmos, D. de Bono, J. S. Attard, G. Cancer Research UK; Department of Health [C51/A7401]; NHS The authors are employees of the Section of Medicine that is supported by a Cancer Research UK programme grant and an Experimental Cancer Medical Centre (ECMC) grant from Cancer Research UK and the Department of Health (Ref: C51/A7401). GA is also supported by a Cancer Research UK Clinician Scientist Fellowship. We acknowledge NHS funding to the Royal Marsden NIHR Biomedical Research Centre. The clinical studies were sponsored by Cougar Biotechnology, now a unit of Johnson and Johnson, who were, however, not involved in this post-hoc analysis. Nature publishing group London
Uncontrolled Keywords: castration-resistant prostate cancer sarcopenia abiraterone acetate i clinical-trial deprivation therapy increased survival skeletal-muscle acetate cyp17 inhibitor glucocorticoids chemotherapy carcinoma
Research teams: ICR divisions > Cancer Therapeutics > Cancer Biomarkers
ICR divisions > Clinical Studies > Cancer Biomarkers

ICR divisions > Clinical Studies > Prostate Cancer Targeted Therapy Group
Depositing User: Alexander Smithson
Date Deposited: 27 Aug 2013 11:44
Last Modified: 07 Jul 2017 15:50
URI: http://publications.icr.ac.uk/id/eprint/12672

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