Efficacy of AA in patients with metastatic CRPC after progression on DES: Potential cost-efficient treatment paradigm.

e16100 Background: , Sequential hormonal deprivation therapy incorporating old inexpensive pharmaceuticals may still have a role in the treatment of castrate resistant metastatic prostate carcinoma(CRPC). Abiraterone Acetate(AA), a CYP 17 inhibitor, initially approved by the FDA for CRPC in the post chemotherapy setting after showing improvement in OS, PFS, PSA and clinical response attained approval in the chemotherapy naive patient essentially resulting in the majority of patients receiving this agent earlier in their disease course. Diethylstilbestrol(DES) is a nonsteroidal estrogen, first used for CRPC in 1941 . The effectiveness of orchiectomy, LHRH agonists, and the cardiovascular toxicity associated with DES has relegated it to a minor role in the treatment of CRPC. One month supply AA costs $6,285 compared to one month DES $114. Methods: Patient records at a single large academic center were reviewed if they had been treated for metastatic CRPC first with DES and at time of progression later had r...