Hot Paper in Medicine

January 2015
“Abiraterone in metastatic prostate cancer without previous chemotherapy,” by C.J. Ryan, et al., New England Journal of Medicine, 368(2): 138-48, 10 January 2013.

Abstract: “BACKGROUND Abiraterone acetate, an androgen biosynthesis inhibitor, improves overall survival in patients with metastatic castration-resistant prostate cancer after chemotherapy. We evaluated this agent in patients who had not received previous chemotherapy. METHODS In this double-blind study, we randomly assigned 1088 patients to receive abiraterone acetate (1000 mg) plus prednisone (5 mg twice daily) or placebo plus prednisone. The coprimary end points were radiographic progression-free survival and overall survival. RESULTS The study was unblinded after a planned interim analysis that was performed after 43% of the expected deaths had occurred. The median radiographic progression-free survival was 16.5 months with abiraterone-prednisone and 8.3 months with prednisone alone (hazard ratio for abiraterone-prednisone vs. prednisone alone, 0.53; 95% confidence interval [CI], 0.45 to 0.62; P<0.001). Over a median follow-up period of 22.2 months, overall survival was improved with abiraterone-prednisone (median not reached, vs. 27.2 months for prednisone alone; hazard ratio, 0.75; 95% CI, 0.61 to 0.93; P = 0.01) but did not cross the efficacy boundary. Abiraterone-prednisone showed superiority over prednisone alone with respect to time to initiation of cytotoxic chemotherapy, opiate use for cancer-related pain, prostate-specific antigen progression, and decline in performance status. Grade 3 or 4 mineralocorticoid-related adverse events and abnormalities on liver-function testing were more common with abiraterone-prednisone. CONCLUSIONS Abiraterone improved radiographic progression-free survival, showed a trend toward improved overall survival, and significantly delayed clinical decline and initiation of chemotherapy in patients with metastatic castration-resistant prostate cancer.”

This 2013 report from the New England Journal of Medicine was cited 48 times in current journal articles indexed by Thomson Reuters during September-October 2014. No other Clinical Medicine paper indexed by Thomson Reuters in the last two years, aside from reviews, attracted a higher number of citations during that two-month period. Prior to the most recent bimonthly count, citations have accrued as follows, as tracked by Essential Science Indicators Hot Papers:

July-August 2014: 23 citations
May-June 2014: 33
March-April 2014: 31
January-February 2014: 31
November-December 2013: 33
September-October 2013: 17
July-August 2013: 14
May-June 2013: 19
March-April 2013: 10
January-February 2013: 1

Total citations to date: 260

SOURCE: Thomson Reuters Web of Science

The data and citation records included in this report are from Thomson Reuters Web of ScienceTM. Web of ScienceTM is a registered trademark of Thomson Reuters. All rights reserved.