Saké to me.

This prospective observational study of 203 Japanese men with metastatic castrate-sensitive prostate cancer (mCSPC) assesses how serum genotyping of HSD3B1 predicts response to two common treatment pathways. As expected, among men receiving first-line androgen deprivation therapy (ADT) alone, harboring either a heterozygous or homozygous variant allele of HSD3B1 meant a significantly higher risk for clinical progression (HR 2.3). Conversely, among men receiving upfront combo of ADT + abiraterone, harboring a variant allele meant a significantly lower risk of progression (HR 0.3) and even death (HR 0.4). Now this is surprising.HSD3B1 mutations are generally thought to portend a bad prognosis across the board, but these authors hypothesize such variants may in fact aid in more effective metabolism of abiraterone. TBL: HSD3B1 status may pan out to be a helpful addition to treatment algorithms in mCSPC. | Shiota, JAMA Netw Open 2019