Remarkable response to abiraterone acetate in castration-resistant prostate cancer patient with aggressive liver metastasis

Introduction The number of treatment options for metastatic castration-resistant prostate cancer has increased in recent years. Abiraterone, which selectively inhibits CYP17 in the androgen synthesis pathway, is widely used. Liver metastasis is one of the worst prognostic factors in metastatic castration-resistant prostate cancer. Only a few case reports have shown abiraterone successfully treated the liver metastasis of metastatic castration-resistant prostate cancer. Case presentation A 62-year-old man with prostate-specific antigen of 16.69 ng/mL was diagnosed with Gleason 8 (3 + 5) poorly differentiated prostate adenocarcinoma. Androgen deprivation therapy and sequential anti-androgen replacement were performed; however, the disease advanced to castration-resistant prostate cancer with liver metastasis. Prior to docetaxel, abiraterone achieved marked improvements in liver metastasis and prostate-specific antigen. Conclusion Metastatic castration-resistant prostate cancer patients with visceral metastasis were excluded from COU-AA-302, which is phase III trial on abiraterone prior to docetaxel. Although docetaxel is the recommended treatment for the visceral metastasis of castration-resistant prostate cancer according to the European Association of Urology guidelines, abiraterone also has potential as a treatment option.