“For decades, millions of men with early prostate cancer have been placed on drug therapy to suppress their production of testosterone, despite such significant side effects as impotence, diabetes and bone loss. Now a large new analysis has concluded that so-called androgen deprivation therapy does not extend the lives of these patients.
“ ‘There are so many side effects associated with this therapy, and really little evidence to support its use,’ said Dr. Grace L. Lu-Yao, a researcher at the Rutgers Cancer Institute of New Jersey and the lead author of the report, published on Monday in JAMA Internal Medicine. ‘I would say that for the majority of patients with localized prostate cancer, this is not a good option. ”
“Dr. Lu-Yao and her colleagues followed tens of thousands of men with early prostate cancer for as long as 15 years and found that those who received androgen deprivation therapy lived no longer on average than those who did not. The study joins a growing body of evidence indicating that for many men with early prostate cancer, avoiding testosterone-suppressing drugs altogether may be better than grappling with their potentially devastating toll.”
“One expert who was not involved in the new study, Dr. James M. McKiernan, acting chairman of urology at NewYork-Presbyterian Hospital/Columbia University Medical Center said its findings were ‘eye-opening and even alarming.’ ”
“Anti-androgen hormonal therapy, also called chemical castration, can be an important defense against further disease progression for patients with prostate cancer that has traveled and grown in other areas, or metastasized—but some cases simply do not respond to this treatment. A groundbreaking molecular imaging agent has been developed to help clinicians find as much cancer as possible, whether it is responding favorably or not, in an effort to improve clinical decision making for these patients, say researchers at the Society of Nuclear Medicine and Molecular Imaging’s 2014 Annual Meeting.”
“A combination attack on androgens in metastatic prostate cancer resistant to initial hormone therapy drove down testosterone levels and appeared safe, according to a proof of concept study.
“Enzalutamide (Xtandi) plus abiraterone (Zytiga) dropped blood and bone marrow androgens down to undetectable levels for 80% of such patients, reported Eleni Efstathiou, MD, PhD, of the MD Anderson Cancer Center in Houston.
Editor’s note: This article discusses a treatment that may benefit men with metastatic prostate cancer that has become resistant to hormonal therapy (a condition known as castration-resistant prostate cancer or CRPC). The treatment, which combines the drugs enzalutamide (Xtandi) and abiraterone (Zytiga), was tested in a study with volunteer patients. The treatment appeared safe and also lowered testosterone levels—a promising sign that indicates potential cancer-fighting power. More studies will have to be done to determine just how well the treatment might work.
“A drug used to treat men with late-stage prostate cancer proved effective in stemming progression of the disease in research participants who had not yet received chemotherapy and extended their survival, according to results from a multi-national Phase III clinical trial led by the Knight Cancer Institute .
“A comprehensive analysis of the study’s results ― published in June 1 online edition of the New England Journal of Medicine and to be presented at the American Society of Clinical Oncology (ASCO) annual meeting in Chicago ― found participants treated with enzalutamide saw an 81 percent reduction in the risk the cancer would progress and a 29 percent reduction in the risk of death. The oral medication, which is marketed under the brand name Xtandi®, also helped prevent the spread of the disease to the bones, delayed the need for chemotherapy, and reduced evidence of prostate cancer in the bloodstream.
” ‘Based on the study results, this drug could fill an important gap in prostate cancer treatment today. The strong response to this new use of enzalutamide shows that it can provide a viable, less toxic alternative to chemotherapy in staving off the disease in men who aren’t responding to standard first line hormonal treatments,’ said Tomasz Beer, M.D., the lead author on the study and deputy director of the Knight Cancer Institute at OHSU.”
“A cheap, decades-old chemotherapy drug extended life by more than a year when added to standard hormone therapy for men whose prostate cancer has widely spread, doctors reported Sunday.
“Men who received docetaxel, sold as Taxotere and in generic form, lived nearly 58 months versus 44 months for those not given the drug, a major study found.
” ‘This is one of the biggest improvements we’ve seen in survival in adults with any type of cancer that has widely spread from its original site,’ said Dr. Christopher Sweeney of Dana-Farber Cancer Institute in Boston. He led the study and shared the results Sunday at the American Society of Clinical Oncology’s annual conference in Chicago.”
Editor’s note: This story describes the findings of a clinical trial, a study done with volunteer patients to test a new treatment. The clinical trial found that a chemotherapy drug called docetaxel (brand name Taxotere) extended survival by more than a year when taken in combination with standard hormone therapy for men with metastatic prostate cancer.
“Many men with an early sign of a prostate cancer relapse can safely wait before starting hormone therapy, avoiding side effects without shortening their lives, according to the results of a study released on Wednesday.
“Dr. Clifford A. Hudis, president of the American Society of Clinical Oncology, said the study ‘certainly does not provide evidence that you have to rush in with treatment, and it does provide comfort if you choose for any reason to withhold treatment at the beginning, that you’re probably not risking much.’ “
“Progenics Pharmaceuticals, Inc. (Nasdaq:PGNX) an oncology company focused on the development of innovative approaches to targeting and treating prostate cancer, announced today the completion of enrollment in the chemotherapy naïve cohort in its Phase II trial of PSMA ADC. This cohort of 36 chemotherapy naïve prostate cancer patients, all of whom progressed on hormonal therapies, was added to the Phase II trial following positive response to PSMA ADC in patients in the chemotherapy experienced setting.”
Editor’s note: This story is about clinical trial NCT01695044. The trial is testing a treatment called PSMA ADC for patients with metastatic, castration-resistant prostate cancer. Clinical trials can be good treatment options for some patients. Learn more about them here.
“Prostate cancer becomes deadly when anti-hormone treatments stop working. Now a new study suggests a way to block the hormones at their entrance.
“Researchers from the University of Michigan Comprehensive Cancer Center have found that a protein called BET bromodomain protein 4 binds to the hormone androgen receptor downstream of where current therapies work – targeting androgen receptor signaling.
“This could mean that when prostate cancer becomes resistant to current treatments, it might remain sensitive to a drug that targets BET bromodomain proteins. Results appear inNature.”
Editor’s note: The drug described in this story, JQ1, will likely soon be offered to prostate cancer patients through clinical trials.
“Controversial new research may overturn the standard treatment of men with advanced prostate cancer. Work indicates that men with advanced prostate cancer could have a better chance of surviving if they undergo treatment directed specifically at the prostate (so-called ‘radical’ therapy) as well as hormonal treatment.”