And the Answer Is...
Answer: False
Abiraterone acetate (AA) is a common treatment of metastatic castration-resistant prostate cancer (mCRPC), and taking the therapy with meals has been shown to increase the drug’s serum concentrations. Is the therapy’s “food effect” a serious concern? Not necessarily, at least over the short term. In fact, the authors of a study published in the journal Prostate Cancer and Prostatic Diseases suggested increased serum concentrations caused by taking the drug with food could inhibit additional enzymes in the androgen synthesis pathway that are associated with progression of mCRPC. Their research showed that prostate-specific antigen (PSA) decreased in 3 of 19 men with mCRPC who switched from fasting to eating while taking AA. In addition, the median time on the therapy increased by nearly 100 days in men who first ate then fasted. The researchers said taking AA with food could prove beneficial, but more research is needed before definitive conclusions are made.
The authors of another study published in the Journal of Clinical Pharmacology assessed men with mCRCP who took 1,000 mg of AA plus 5 mg of mg prednisone twice daily first while fasting and then within 30 minutes of eating a low- or high-fat meal. The blood concentration level of AA was 2 times higher after a high-fat meal than after a low-fat meal compared with patients who fasted, according to the findings. Adverse events were relatively minor and similar in all patients. Taking AA with food, particularly a low-fat meal, did not have a significant short-term effect on the drug’s exposure or related side effects, according to study lead author Dr. Kim N. Chi, a medical oncologist at the Vancouver Cancer Centre in Canada.
AA’s manufacturer, which markets the drug as Zytiga, warns that taking the drug with food may increase the medicine’s absorption and subsequent side effect risks. Dr. Chi said it’s best to stick to the directives on the label by telling patients to fast instead of feast, but also said physicians and pharmacists shouldn’t be too concerned if patients inadvertently take the drug with food for a short time.
—Dan Cook
