Feasibility of abiraterone acetate treatment in patients with metastatic castration-resistant prostate cancer and atrial fibrillation

BACKGROUND: Abiraterone acetate (AA), a selective inhibitor of the CYP17 enzyme, demonstrated a significant improvement in the treatment of patients with metastatic castration-resistant prostate cancer. The risk of endocrine side effects, mainly an increased adrenal mineralocorticoid production, could limit its use in patients with atrial fibrillation. METHODS: We retrospectively reviewed the clinical records of 85 metastatic castration-resistant prostate cancer patients treated with AA at our institutions and identified six patients suffering from concomitant atrial fibrillation. RESULTS: In these six patients, the median duration of AA treatment was 11.5 months (range 4–22 months) with a biochemical response in three patients. No significant cardiac events were observed during the treatment. CONCLUSION: Our data suggest that AA may be safely administered in patients with atrial fibrillation.