This study provides initial data on mCRPC patients undergoing therapy with Zytiga (abiraterone/prednisone) and suggests that the efficacy may not be compromised if LHRH therapy (such as Lupron or Firmagon) is discontinued. The primary endpoint of this study was radiographic progression-free survival (rPFS) at 1 year and there was no significant difference between the 2 arms. It was a small study with just 67 patients. To read the full ASCO Conference summary written by Jason Zhu, MD., Duke University, click here: http://tiny.cc/fs9w7y
I’m afraid this is a highly technical blog post, but the “take home message” for you should be that having your Advanced PCa genome sequenced for actionable targets (biomarkers) can do much to inform both you and your oncologist on which treatments are likely to benefit you most and which are likely to fail. At the ASCO Conference, Dr. Isla Garraway, David Geffen School of Medicine, UCLA, led a discussion of several of the talks given at the Conference pertaining to predictive biomarkers. Below are a few highlights. For the full summary of her discussion, click here: https://urlzs.com/ZLFxV
RB1 loss is a poor prognostic sign in mCRPC
Compound loss of PTEN + RB1 and TP53 + RB1 demonstrates significantly worse outcomes to mCRPC treatments compared to single or no ‘hits’
HDSB31(1245C) variant consistently demonstrates value as a prognostic/predictive biomarker, showing ADT-resistance and shorter OS in men with low volume mCSPC
PTEN/TP53 and DNA damage repair alterations are enriched in mCSPC primary tumors
Final results from the CABADOC trial reveal that for 195 men who were randomized to receive either docetaxel followed by cabazataxel or vice versa, as treatment for their mCRPC, more men preferred cabazitaxel based on QoL issues such as fatigue, hair loss and/or pain. There was no difference in efficacy.
A retrospective analysis of 3,065 patients with high-risk localized or locally advanced prostate cancer treated with IMRT in the English National Health Service between 2010 and 2013 was performed. The analysis compared GI and genitourinary (GU) complications for Prostate Only-IMRT versus Prostate + Whole Pelvic Lymph Node-IMRT. Three-year cumulative incidence was 14% for both groups for GI toxicity, and 9% and 8% for GU toxicity, for Prostate+PLN and Prostate-Only RT, respectively. The authors conclude that “Including PLNs in radiation fields for high-risk or locally advanced prostate cancer is not associated with increased GI or GU toxicity at 3 years.”
The Language of Cancer is controversial and here is yet another example in yesterdays CureToday. Mark your calendars for 8 pm EDT on Monday, July 29, 2019 for an AnCan webinar on The Language of Cancer. Our panel will include Howard Wolinsky, cited in this article, and possibly Jane Biehl herself!
This blogger’s personal opinion is simply ‘live and let live’. If certain words motivate some people, recognize they are not intended to offend others and don’t take them personally. Cancer is very personal … surely we should allow each individual living with cancer to use the words that suit them best. And for those not living with cancer, recognize they are not directing their words personally, but generally.
Taking prednisone with abiraterone (Zytiga); debulking the primary tumor for men with mets; CAR-T trials for prostate cancer; APCEDEN – Provenge alternative; PCRI Conference; comparing 2nd line anti-androgen drugs – is one the best?
Some of you may may know already this is ASCO week in Chicago. Prof Bill Burhans, our Board & Advisory Board member is acutely aware since he finds himself back in Roswell Park Hospital with all his docs AWOL! Here at AnCan we are all hoping this is a bit of a false alarm, wish him very well and home soon.
This annual ASCO summer gathering of over 30,000 medics, journalists, advocates and others frequently provides a forum to release important results from clinical trials for all cancers. Prostate cancer is no exception, and we have already seen excellent results from the TITAN trial for the use of apalutamide (Erleada) in metastatic, hormone sensitive disease. In this double blind trial, not only has it outperformed the placebo and now been unblinded, but more importantly there appear to be no statistically significant side effect differences between the two arms. You can read the abstract here.
AnCan and MedaFit have long been aggressive proponents of the importance of exercise to manage cancer, and in particular prostate cancer.
This short interview between one of AnCan’s favorite GU med oncs, Alicia Morgans at Northwestern and Lorelei Mucci ScD at Harvard examines a recent epidemiological study using the 50,000 male healthcare professionals cohort over 30 years. It finds that amongst the 6,000 men who contracted prostate cancer, those with advanced PCa who engaged in 25 minutes of VIGOROUS (heavy aerobic) exercise daily had a 30% lower risk of developing lethal prostate cancer. Moderate exercise did not show the same results.
MedaFit has been pushing this hypothesis going back to 2007 and is proud to be one of the catalysts bringing about greater academic study of exercise and prostate cancer.
Meet @Tall Allen – Allen Edel; 18F-DCFPyl PSMA scan; radiation proctitis treatments; debulking the primary tumor; scanning tube anxiety; blood clots and treatment; blastic v lytic bone mets; when your med onc switches jobs; penile rehab after hormone therapy; success with metastatic spot radiation; 2nd line anti-androgen comparisons
Researchers at the Univ. of Minnesota conducted a retrospective study of 57 consecutive men with mCRPC followed for one year and found that testosterone levels were suppressed equally whether the men were given Zytiga alone or Zytiga plus ADT drugs such as Lupron and Firmagon. This can provide substantial cost savings for the patients and for society. You can read the full 2019 ASCO abstract here: http://abstracts.asco.org/239/AbstView_239_266583.html
