From the FDA Drug Label
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From the Research
Abiraterone plus Lupron (leuprolide) is typically given for 2 years after completion of external beam radiation therapy (EBRT) for high-risk prostate cancer. The standard approach involves continuing Lupron for a total of 24-36 months after radiation, with abiraterone (1000 mg daily) plus prednisone (5 mg daily) added to this regimen. This combination therapy is most beneficial for patients with high-risk or locally advanced prostate cancer. The rationale behind this extended hormonal therapy is that prostate cancer cells are typically androgen-dependent, and the dual blockade approach (Lupron blocks testosterone production while abiraterone inhibits androgen synthesis pathways) provides more complete androgen suppression. This combination has been shown to improve metastasis-free survival and overall survival compared to androgen deprivation therapy alone, as demonstrated in a study published in 2018 1. Patients should be monitored regularly for side effects including fatigue, hypertension, hypokalemia, liver function abnormalities, and cardiovascular complications. Treatment duration may be individualized based on risk factors, patient tolerance, and response to therapy, with some studies suggesting that treatment beyond prostate-specific antigen and radiographic progression can improve overall survival 2. However, the most recent and highest quality study, published in 2021, suggests that external beam radiation therapy can improve survival in elderly metastatic prostate cancer patients with low PSA, which may inform treatment decisions for patients with similar characteristics 3. Overall, the combination of abiraterone and Lupron has been shown to be safe and effective, with a tolerability profile that is generally acceptable, predictable, and manageable, and an improvement in patient's perceived quality of life 4.