SHM Converge Scientific Abstract ePoster Gallery-Abiraterone-Induced Liver Injury in Advanced Prostate Cancer Management

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This case report describes a 53-year-old man with advanced prostate cancer who developed abiraterone-induced liver injury. He was diagnosed in September 2021 with aggressive adenocarcinoma, indicated by a PSA of 111 and a high Gleason score. Initial treatment with androgen deprivation therapy and radiation began in February 2022 but was stopped because testosterone suppression was inadequate. Abiraterone plus prednisone was started in March 2022.<br /><br />Soon after starting abiraterone, liver tests became abnormal. In April 2022, ALT and AST rose to 87 and 41, prompting temporary discontinuation of the drug. When abiraterone was briefly restarted in late May, liver enzymes worsened again. By June 2022, the patient was hospitalized with abdominal pain and marked transaminase elevation (ALT 456, AST 194), leading to a diagnosis of drug-induced liver injury attributed to abiraterone. After the medication was stopped, liver enzymes improved but remained elevated. Imaging later showed persistent hepatic steatosis, and a liver biopsy in April 2023 confirmed steatohepatitis and macrovesicular steatosis.<br /><br />The report emphasizes that although abiraterone is an effective therapy for metastatic castration-resistant prostate cancer, it can cause serious hepatotoxicity. Regular liver function monitoring is essential, especially in patients with risk factors for liver disease. The case also highlights the importance of multidisciplinary care, early recognition of liver injury, and patient education. Overall, it reinforces the need to balance cancer treatment benefits against potential adverse effects and to individualize therapy carefully.

Asset Subtitle

Matthew Lee

Meta Tag

Author List Jue Wang, Matthew Lee, Phillip Taboada

Category Clinical Vignettes

Concept Abiraterone

Concept Drug-Induced Liver Injury

Concept CYP17 Inhibitor

Concept Metastatic Castration-Resistant Prostate Cancer

Concept Hepatotoxicity

Distinguished Non-Finalist

Presenter Organization UT Southwestern Medical School

Presenting Author Matthew Lee

Track Adult

Keywords

abiraterone

liver injury

hepatotoxicity

prostate cancer

drug-induced liver injury

transaminase elevation

androgen deprivation therapy

hepatic steatosis

steatohepatitis

prednisone

Abiraterone

Drug-Induced Liver Injury

CYP17 Inhibitor

Metastatic Castration-Resistant Prostate Cancer

Hepatotoxicity