Impact of <i>CYP17A1</i> Gene Polymorphisms on Abiraterone Efficacy in Prostate Cancer: A Systematic Review

Background Abiraterone acetate is a second-generation androgen biosynthesis inhibitor widely used in the treatment of metastatic castration-resistant prostate cancer (mCRPC). However, resistance to abiraterone remains a major clinical challenge. Polymorphisms in genes involved in steroidogenesis, such as CYP17A1, may influence abiraterone therapeutic outcomes. Methods A systematic review of PubMed, Scopus, and ScienceDirect was conducted to examine the association between CYP17A1 polymorphisms and abiraterone treatment outcomes. Results Out of 518 articles initially identified through keyword search, five studies were eligible for qualitative analysis. Among them, three studies reported an association between polymorphisms rs2486758, rs743572 and abiraterone outcome—the associations are biochemical response, Progression-free survival (PFS), Overall survival (OS) and toxicity. Other polymorphisms, including rs4919685, rs17115100, rs743572, rs10883783, rs284849 did not show consistent associations. Conclusion Due to the heterogeneity in study designs, it would be difficult to state with conviction whether or not there is a statistically significant association between these polymorphisms and response to abiraterone. Larger prospective studies are needed. However, rs2486758 is the most consistently associated CYP17A1 variant with abiraterone response.