抄録
Abiraterone acetate is used to treat high-risk hormone-sensitive prostate cancer and metastatic castration-resistant prostate cancer. However, drug-induced liver injury is a complication of abiraterone acetate administration. Drug-induced liver injury can be categorized as hepatocellular, cholestatic, or mixed type based on the R ratio derived from the ratio of alanine aminotransferase to alkaline phosphatase. Case 1: An 87-year-old man experienced liver injury caused by abiraterone acetate treatment of metastatic hormone-sensitive prostate cancer. Grade 4 aspartate aminotransferase and alanine aminotransferase increasing were observed for 6 weeks after treatment. The R ratio was 27.5; therefore, the drug-induced liver injury was diagnosed as the hepatocellular type. Case 2: A 66-year-old man experienced liver injury caused by abiraterone acetate treatment of metastatic castration-resistant prostate cancer. Four weeks after treatment, Grade 3 aspartate aminotransferase, Grade 4 alanine aminotransferase, and Grade 3 γ-glutamyl transpeptidase increasing were observed. The R ratio was 7.0; therefore, the drug-induced liver injury was diagnosed as the hepatocellular type.Case 3: A 74-year-old man experienced liver injury caused by abiraterone acetate treatment of metastatic hormone-sensitive prostate cancer. Four weeks after treatment, Grade 3γ-glutamyl transpeptidase and Grade 3 alkaline phosphatase increasing were observed. The R ratio was 0.4; thus, the drug-induced liver injury was diagnosed as cholestatic type. Severe drug-induced liver injury is a potential complication of abiraterone acetate therapy. Monitoring of liver function is recommended at least every 2 weeks for the first 3 months of treatment.
