In a recent clinical study, the prostate cancer drug enzalutamide decreased prostate-specific antigen (PSA) blood levels by an average of 99.6% in patients with prostate cancer who had not previously been treated with hormone therapy. Of the 67 patients involved in the study, 93% had a decline in PSA levels. Enzalutamide is an androgen receptor blocker that is currently approved by the FDA to treat men with metastatic castration-resistant prostate cancer (mCRPC) who have previously been treated with the chemotherapy drug docetaxel. The study results suggest that the drug may be an effective initial treatment for men with locally advanced prostate cancer, without the unwanted side effects associated with current hormone treatments known as androgen deprivation therapy.
In a phase I clinical trial, a new drug called ODM-201 was found to be effective and well tolerated by men with prostate cancer. Preclinical studies indicate that the androgen receptor-blocking drug may be more potent than the recently approved drug enzalutamide. The phase I clinical trial has been expanded and a phase II clinical trial is ongoing.
Results of a clinical trial that evaluated the prostate cancer vaccine Provenge have come under scrutiny. Questions arise regarding the reported 4-month survival benefit that ultimately led to FDA approval. Disputers suggest that a flaw in methods led to the survival benefit, but that the vaccine may actually cause harm.
A recent study evaluated the usefulness of surgery versus observation to treat localized prostate cancer. In the study, 731 men were followed for 10 years. Those treated with surgery did not have a significant decreased risk of death compared to those who were observed for advancing cancer.
A recent study weighed the benefits of yearly prostate cancer screening, finding that the potential disadvantages decrease the potential advantages by 23%. Harmful results of yearly prostate screening include negative prostate biopsies, radical prostatectomy, and radiation therapy.
A recent study found a relationship between the SPARCL1 gene and prostate cancer recurrence. Individuals who had lower activity of the gene had a higher risk of prostate cancer recurrence over 10 years. A test to detect SPARCL1 is being designed.
The New England Journal of Medicine | Oct 25, 2012
The utility of (prostate-specific antigen) PSA screening to inform prostate cancer diagnosis and treatment has been a topic of heated debate. The New England Journal of Medicine (NEJM) conducted a poll that indicates a lack of consensus among clinicians regarding best prostate cancer screening practices. Many clinicians feel patients should make informed decisions regarding testing preferences.
The FDA has approved enzalutamide (sold as Xtandi) 3 months ahead of deadline. The drug improved survival by nearly 5 months in men with advanced prostate cancer. It is approved for individuals who have not responded to chemotherapy. However, manufacturers hope to expand approval to include patients not previously treated with chemotherapy.
A recent study evaluated androgen deprivation therapy with and without radiation therapy in individuals with locally advanced prostate cancer. Individuals who received combination treatment had a better overall survival rate. Bowel-related side effects were similar for both groups 24 months after treatment.