Effect of Food on Abiraterone Pharmacokinetics: A Review

Recent reports suggest a potentially beneficial increase in abiraterone exposure when abiraterone acetate plus prednisone is administered with food. We evaluated the basis for current dosing recommendations under modified fasted conditions for patients with metastatic castration-resistant prostate cancer with a PubMed search of studies assessing the impact of food on abiraterone pharmacokinetics. Studies show that abiraterone exposure increases with administration in a fed versus fasted state and with high-fat versus low-fat meals. Food effect is substantially attenuated in metastatic castration-resistant prostate cancer patients compared with healthy subjects. The potential variability in absorption, unproven clinical benefits and increased toxicity with abiraterone acetate plus prednisone administration in the fed state underscore the importance of adhering to current dosing recommendations.