# PTEN protein loss and clinical outcome from castration-resistant prostate cancer treated with abiraterone acetate

Source: https://onco.cc/key-papers/paper-ferraldeschi-pten-protein-loss-abiraterone-eur-urol-2015/  
OnCo record `paper-ferraldeschi-pten-protein-loss-abiraterone-eur-urol-2015` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Staining tumour samples from 144 men showed that the 40% who had lost a particular protein lived about seven months less on abiraterone.

## Summary

Men who had received abiraterone and had hormone-sensitive or castration-resistant prostate cancer tissue available for PTEN immunohistochemistry were identified retrospectively, with overall survival from the start of abiraterone as the primary endpoint. One hundred and forty-four men who had received abiraterone after docetaxel had available tumour tissue. Loss of PTEN expression was observed in 40%. Matched hormone-sensitive and castration-resistant tumour biopsies were available for 41 men, and PTEN status in castration-resistant tissue matched the hormone-sensitive tissue in 86% of those cases. Loss of PTEN expression was associated with shorter median overall survival, 14 against 21 months, hazard ratio 1.75, and shorter median duration of abiraterone treatment, 24 against 28 weeks, hazard ratio 1.6. PTEN protein loss, high lactate dehydrogenase and visceral metastases were independent prognostic factors on multivariable analysis.

## Fields

- Kind: Key paper
- Last checked: 2026-09-25
- Journal: European Urology
- Year: 2015
- DOI: 10.1016/j.eururo.2014.10.027
- Authors: Ferraldeschi R, Nava Rodrigues D, Riisnaes R, et al.
- Findings: PTEN protein loss in 40% of 144 men treated with abiraterone after docetaxel.; Median overall survival 14 against 21 months with PTEN loss, hazard ratio 1.75.; PTEN status concordant between hormone-sensitive and castration-resistant biopsies in 86% of 41 paired cases.; PTEN loss an independent prognostic factor alongside lactate dehydrogenase and visceral disease.
- What it means: It made PTEN a protein test rather than a genomic one in this disease, and the concordance between early and late biopsies is the practical point: the diagnostic block usually answers the question, so a fresh biopsy is not needed to make this call.
- Caveats: Retrospective and single-institution, in men treated after docetaxel.; Immunohistochemistry for PTEN is notoriously assay-dependent, which is why the phase 3 trial specified a single validated assay.; Prognostic, and it does not by itself say abiraterone should be withheld.

## Sources

- Ferraldeschi et al., Eur Urol 2015: PTEN protein loss by immunohistochemistry and outcome on abiraterone in 144 men: https://doi.org/10.1016/j.eururo.2014.10.027
- PubMed: https://pubmed.ncbi.nlm.nih.gov/25454616/

## Connected records

- cancers: [Metastatic castration-resistant prostate cancer](https://onco.cc/cancers/prostate-mcrpc/), [Prostate cancer](https://onco.cc/cancers/prostate/)
- technologies: [Histopathology & immunohistochemistry](https://onco.cc/technologies/histopathology-ihc/)
- targets: [AKT](https://onco.cc/targets/akt/), [PTEN](https://onco.cc/targets/pten/)
- drugs: [Abiraterone acetate](https://onco.cc/drugs/abiraterone/)
- pathways: [Androgen receptor signalling](https://onco.cc/pathways/ar-signaling/), [PI3K / AKT / mTOR](https://onco.cc/pathways/pi3k-akt-mtor/)
- terms: [Castration-resistant prostate cancer (CRPC)](https://onco.cc/terms/castration-resistance/), [Drug resistance (primary and acquired)](https://onco.cc/terms/resistance/), [Immunohistochemistry (IHC)](https://onco.cc/terms/ihc/)
- journals: [European Urology](https://onco.cc/journals/european-urology/)
- biomarkers: [PTEN alteration (sequencing) and PTEN loss (IHC)](https://onco.cc/biomarkers/pten-alteration/)

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