Capivasertib Plus Abiraterone in Metastatic Prostate Cancer
Key Points
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The CAPItello-281 trial evaluated the addition of the AKT inhibitor capivasertib to abiraterone and androgen deprivation therapy (ADT) in prostate cancer.
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CAPItello-281 met its primary endpoint, demonstrating a strong improvement in rPFS when capivasertib was added to ADT plus abiraterone.
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Radiographic progression-free survival (rPFS) in androgen pathway modulator–sensitive prostate cancer was improved with the combination, but there was no overall survival (OS) benefit.
Results from the CAPItello-281 trial presented at the 2026 ASCO Genitourinary Cancers Symposium highlight ongoing efforts to refine targeted strategies in prostate cancer. In a discussion between Karan Jatwani, MD, of George Washington University Cancer Center, and Alan Bryce, MD, of City of Hope, the experts reviewed PFS and OS data with the use of the AKT inhibitor capivasertib plus abiraterone and ADT.
CAPItello-281 evaluated capivasertib in patients with androgen pathway modulator–sensitive prostate cancer, a term now favored over castration-resistant prostate cancer following updated recommendations from the Prostate Cancer Working Group 4, according to Dr. Bryce.
The study met its primary endpoint, demonstrating a strong improvement in rPFS when capivasertib was added to ADT plus abiraterone. However, OS improvement was not observed in the study. This result raises questions about the clinical significance of the findings, Dr. Bryce said.
He added that toxicity plays a major role when evaluating therapies that improve PFS but not OS. Adverse events (AEs) seen with capivasertib include gastrointestinal toxicities like diarrhea, dermatologic reactions like rash, and metabolic complications, including hyperglycemia.