3-Keto-5α-abiraterone

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A steroidal antiandrogen and metabolite of abiraterone


3-Keto-5α-abiraterone (3-keto-5α-AB) is a steroidal antiandrogen and a major active metabolite of the androgen synthesis inhibitor abiraterone acetate, which is used in the treatment of prostate cancer.

Chemical structure and properties

3-Keto-5α-abiraterone structure

3-Keto-5α-abiraterone is a derivative of abiraterone, which is a synthetic steroidal compound. The chemical structure of 3-keto-5α-abiraterone is characterized by the presence of a 3-keto group and a 5α-reduced configuration. This structural modification is crucial for its biological activity as an antiandrogen.

Mechanism of action

3-Keto-5α-abiraterone functions primarily as an antiandrogen. It exerts its effects by binding to the androgen receptor (AR) and inhibiting its activity. This action prevents the activation of androgen-responsive genes, which are essential for the growth and survival of prostate cancer cells. Unlike abiraterone, which inhibits cytochrome P450 17A1 (CYP17A1) and reduces androgen production, 3-keto-5α-abiraterone directly antagonizes the androgen receptor.

Pharmacokinetics

Upon administration of abiraterone acetate, it is rapidly converted in the body to abiraterone. Abiraterone is then further metabolized to 3-keto-5α-abiraterone. This metabolite is believed to contribute significantly to the therapeutic effects of abiraterone acetate in the treatment of prostate cancer. The pharmacokinetic profile of 3-keto-5α-abiraterone includes its absorption, distribution, metabolism, and excretion, which are critical for its efficacy and safety.

Clinical significance

The discovery of 3-keto-5α-abiraterone as a potent antiandrogen has important implications for the treatment of castration-resistant prostate cancer (CRPC). It provides an additional mechanism of action that complements the androgen synthesis inhibition by abiraterone. This dual action may enhance the overall therapeutic efficacy and help overcome resistance to treatment.

Research and development

Ongoing research is focused on understanding the full spectrum of biological activities of 3-keto-5α-abiraterone. Studies are being conducted to explore its potential use in combination therapies and to evaluate its effects in different stages of prostate cancer. The development of analogs and derivatives of 3-keto-5α-abiraterone is also an area of active investigation.

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Contributors: Prab R. Tumpati, MD