Practice changing data and new developments in the management of prostate cancer – ASCO 2010

memo - Magazine of European Medical Oncology - Tập 3 - Trang 164-166 - 2012
M. De Santis1, M. Bachner1
1Kaiser Franz Josef Hospital and ACR-ITR VIEnna/CEADDP and LBI-ACR VIEnna-CTO, Vienna, Austria

Tóm tắt

In the 2010 ASCO meeting valuable information and even practice-changing results for the medical treatment of castration resistant prostate cancer (CRPC) were presented. Focus was put on bone-targeted treatment, chemotherapy for second line use, combinations of standard chemotherapy with different new drugs and data on a novel antiangiogenic compounds. Denosumab was shown to be superior to zoledronic acid in the treatment of patients with bone metastases of CRPC. Cabazitaxel improved survival in CRPC patients who progressed during or after docetaxel. This substance might become the first standard treatment for second line use. There are still concerns about the dose and toxicity. Both new drugs still need to be approved but will change our practice in the management of bone metastases and in the second line setting and enlarge significantly our small armamentarium of medical treatment of CRPC. So far, there is no proven benefit in adding any drug to standard docetaxel. This fact was confirmed by final data analyses of the combination of docetaxel with bevacizumab or calcitriol. Tasquinimod is a promising novel anti-angiogenic compound that delayed disease progression significantly in asymptomatic CRPC patients. A phase III-trial will reveal the true value of this compound. In conclusion, in the 2010 ASCO meeting, valuable new information concerning the medical treatment of CRPC was conveyed which might indeed change our clinical practice.

Tài liệu tham khảo

Saad F, Gleason DM, Murray R, Tchekmedyian S, Venner P, Lacombe L, et al. Long-term efficacy of zoledronic acid for the prevention of skeletal complications in patients with metastatic hormone-refractory prostate cancer. J Natl Cancer Inst, 96(11): 879–882, 2004 Fizazi K, Carducci MA, Smith MR, Damião R, Brown JE, Karsh L, et al. A randomized phase III trial of denosumab versus zoledronic acid in patients with bone metastases from castration-resistant prostate cancer. J Clin Oncol, 28(Suppl; abstr LBA4507): 18s, 2010 Tannock IF, de Wit R, Berry WR, Horti J, Pluzanska A, Chi KN, et al. Docetaxel plus prednisone or mitoxantrone plus prednisone for advanced prostate cancer. N Engl J Med, 351(15): 1502–1512, 2004 Petrylak DP, Tangen CM, Hussain MH, Lara PN Jr, Jones JA, Taplin ME, et al. Docetaxel and estramustine compared with mitoxantrone and prednisone for advanced refractory prostate cancer. N Engl J Med, 351(15): 1513–1520, 2004 Attard G, Greystoke A, Kaye S, De Bono J. Update on tubulin-binding agents. Pathol Biol (Paris), 54(2): 72–84, 2006 Pivot X, Koralewski P, Hidalgo JL, Chan A, Goncalves A, Schwartsmann G, et al. A multicenter phase II study of XRP6258 administered as a 1-h i.v. infusion every 3 weeks in taxane-resistant metastatic breast cancer patients. Ann Oncol, 19(9): 1547–1552, 2008 De Bono JS, Oudard S, Ozguroglu M, Hansen S, Machiels JH, Shen L, et al. Cabazitaxel or mitoxantrone with prednisone in patients with metastatic castration-resistant prostate cancer (mCRPC) previously treated with docetaxel: final results of a multinational phase III trial (TROPIC). J Clin Oncol, 28(Suppl; abstr 4508): 15s, 2010 Kelly WK, Halabi S, Carducci MA, George DJ, Mahoney JF, Stadler WM, et al. A randomized, double-blind, placebo-controlled phase III trial comparing docetaxel, prednisone, and placebo with docetaxel, prednisone, and bevacizumab in men with metastatic castration-resistant prostate cancer (mCRPC): survival results of CALGB 90401. J Clin Oncol, 28(Suppl; abstr LBA4511): 18s, 2010 Scher HI, Chi KN, De Wit R, Berry WR, Albers P, Henick B, et al. Docetaxel (D) plus high-dose calcitriol versus D plus prednisone (P) for patients (Pts) with progressive castration-resistant prostate cancer (CRPC): results from the phase III ASCENT2 trial. J Clin Oncol, 28 (Suppl; abstr 4509): 15s, 2010 Halabi S, Small EJ, Kantoff PW, Kattan MW, Kaplan EB, Dawson NA, et al. Prognostic model for predicting survival in men with hormone-refractory metastatic prostate cancer. J Clin Oncol, 21(7): 1232–1237, 2003 Beer TM, Eilers KM, Garzotto M, Egorin MJ, Lowe BA, Henner WD. Weekly high-dose calcitriol and docetaxel in metastatic androgen-independent prostate cancer. J Clin Oncol, 21(1): 123–128, 2003 Pili R, Haggman M, Stadler WM, Gingrich JR, Assikis VJ, Björk A, et al. A randomized, multicenter, international phase II study of tasquinimod in chemotherapy naïve patients with metastatic castrate-resistant prostate cancer (CRPC). J Clin Oncol, 28(Suppl; abstr 4510): 15s, 2010 Bratt O, Haggman M, Ahlgren G, Nordle O, Bjork A, Damber JE. Open-label, clinical phase I studies of tasquinimod in patients with castration-resistant prostate cancer. Br J Cancer, 101(8): 1233–1240, 2009