Managing advanced prostate cancer: what's going to be presented at

So there are going to be > 180 papers specific to the management of prostate cancer presented at the annual meeting of the American Society of Clinical Oncology (ASCO) starting in Chicago next weekend. Some will be trivial; several will be ?interesting?; a very few will be important.

If you want to look through the complete list of abstracts of the papers on prostate cancer, the easiest thing to do is just to click here. This link will take you to the complete list of prostate cancer-specific abstracts.

Among the list of 180+ prostate cancer-specific papers to be presented, here are the ones that we know already are (perhaps) really important in the current and future management of advanced forms of the disease:

• On Saturday, June 2, Ryan et al. will present the detailed results of the interim analysis of the international, randomized, double-blind, Phase III?trial of abiraterone acetate + prednisone vs. placebo + prednisone in chemotherapy-naive patients with metastatic, castration-resistant prostate cancer (mCRPC). The abstract of this particular paper will not be available until just after midnight on June 1, but we?already know that the results of this trial?are positive, so the?question is, ?What?s new in the details???

• On Sunday, June 3, Hussain et al. will be presenting data from S9346/INT-0162 ? the international, Phase III clinical trial of intermittent (IAD) versus continuous androgen deprivation (CAD) in men with hormone sensitive metastatic prostate cancer. The abstract of this particular paper will not be available until just after midnight on June 2, but we do know that the results of this trial have been described as ?practice changing,? so it is a safe bet that the data show that IAD is at least clinically equivalent to CAD.

• On Monday, June 4, Armstrong et al. will present updated, long-term results of the randomized, Phase II clinical trial of tasquinimod vs. a placebo in men with mCRPC, including data on overall survival. The abstract of this paper is available on line and does suggest a significant survival benefit associated with tasquinimod treatment. A multinational, randomized Phase III trial of tasquinimod is already under way and (hopefully) will be able to confirm these outcome data.

• Also on Monday, June 4, Ileana et al. will present the first data on the use of abiraterone acetate in treatment of men with mCRPC who have already progressed after treatment with docetaxel-based chemotherapy and with enzalutamide (MDV3100). The abstract is available on line now; it suggests that only a subset of men with mCRPC who have received prior treatment with docetaxel and enzalutamide will then respond significantly to third-line tretament with abiraterone acetate + prednisone, but this is a small study and we should not over-interpret these data.

• A third paper to be presented on Monday will be one in which Eisenberger et al. report the final results of a trial originally designed to compare the benefits of immediate vs. delayed hormonal therapy and docetaxel-based chemotherapy after radical prostatectomy in men with high-risk prostate cancer. This study was never able to accrue sufficient patients and so a definitive result from this trial has never been obtained. There is no suggestion from the available data that immediate hormonal therapy + chemotherapy is clinically beneficial in this group of patients; equally, however, we can?t say with certainty that it may not be.

• On Tuesday, June 5, Parker et al. will present updated results of the international, randomized, double-blind, Phase III clinical trial of radium-223 in treatment of men with mCRPC (also known as the ALSYMPCA trial). Again, the abstract of this paper will not actually be available until just after midnight on June 4, but there are rumors that these updated results are better than the data originally presented last September. We shall have to wait to see if that is really true.

• Also on Tuesday, June 5, Chi et al. will present the results of a Phase II clinical trial of OGX-427 + prednisone vs. prednisone alone in the treatment of chemotherapy naive men with mCRPC. The abstract of this paper is already available on line and suggests a real potential clinical benefit to treatment with OGX-427, but this is a small trial and only some of the patients appear to benefit based on this study.

Over the next days we shall also address data from other studies being presented at ASCO, but the ones referenced above are perhaps the most important to those patinets with or at risk for advanced forms of prostate cancer today.

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Filed under: Drugs in development, Living with Prostate Cancer, Management, Treatment Tagged: | advanced, ASCO, castration-resistant, CRPC, metastatic

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