Men with advanced, multi-drug resistant prostate cancer can survive an average 2.4 months longer when taking the chemotherapy drug, cabazitaxel, according to new research. It’s the first medication to show a survival benefit in patients whose disease has progressed after standard chemotherapy and for whom there are currently no approved treatment options.
The new research appears in this week’s ‘ Cancer Special’ issue of The Lancet. Following the results of a randomised trial, cabazitaxel has been given regulatory approval in the USA and is now under consideration by the European Medicines Agency and other regulatory bodies.
Prostate cancer is the most common cancer diagnosed in men in the UK and every year 35,000 men are diagnosed with the illness. The Prostate Cancer Charity says African Caribbean men are three times more likely to develop prostate cancer than white men.
For men with advanced prostate cancer, hormone therapy improves symptoms but for many patients their disease continues to progress. Docetaxel plus prednisone is the ‘gold-standard’ chemotherapy treatment for these patients. However, for men whose cancer becomes resistant to docetaxel there is currently no treatment available that can prolong survival. Until now, mitoxantrone was often given because of its beneficial effects on quality of life.
Prostate cancer
To assess whether cabazitaxel improved overall survival compared with mitoxantrone in men with advanced multi-drug resistant prostate cancer (who had already been treated with docetaxel), an international team led by Johann de Bono, from the Royal Marsden NHS Foundation and The Institute of Cancer Research in the UK, conducted a trial.
755 patients were enrolled from 146 centres across 26 countries and randomly assigned to mitoxantrone (377) or cabazitaxel (378), both in combination with prednisone. The average overall survival was 15•1 months in the cabazitaxel group compared with 12.7 months in the mitoxantrone group.
The authors say: “Cabazitaxel treatment also improved median progression-free survival and time to tumour progression, and resulted in higher rates of tumour and serum prostate-specific antigen (PSA) response than did mitoxantrone.”
However, adverse events were seen more often in patients taking cabazitaxel.
UK availability
Dr Sarah Cant, Head of Policy and Campaigns at The Prostate Cancer Charity, explained via e-mail: “The results of this trial of cabazitaxel are an important step along the journey towards expanding the treatments available for men who are living with an advanced form of the disease that has stopped responding to the existing, limited methods of controlling its progression.
“Whilst clearly an important development, there are still some significant hurdles that the drug will need to overcome before it can be recommended and made available to men living with advanced disease in the UK. At the moment doctors cannot prescribe cabazitaxel to treat prostate cancer as it is yet to be licensed for use in Europe.
Cabazitaxel (previously XRP-6258, tradename Jevtana) is a semi-synthetic derivative of a natural taxoid. It was developed by Sanofi-Aventis and was approved by the U.S. Food and Drug Administration (FDA) for the treatment of hormone-refractory prostate cancer on June 17, 2010. It is a microtubule inhibitor.
Cabazitaxel in combination with prednisone is a treatment option for hormone-refractory prostate cancer following or during docetaxel-based treatment.
British scientists have moved a step closer to developing a simple urine test to identify men at risk of getting prostate cancer.
They have discovered that a protein found in urine is affected by a genetic change linked to the cancer.
More research was needed, but their work could lead to the development of a reliable test costing £5.50 ($8.82).
Prostate cancer is the most common cancer in men in the UK, killing about 10,000 men in Britain every year.
There is currently no routine screening programme in the UK, although men with a family history of the disease can have a prostate specific antigen (PSA) blood test to detect signs of the disease.
But this is notoriously inaccurate and although 10-15% of men will have high enough PSA levels to warrant carrying out a prostate biopsy, only 2-3% will require any treatment.
A drug discovered in the UK could help thousands of men with advanced prostate cancer, experts say.
Trials involving men who had exhausted all other treatment options found abiraterone acetate extended life by an average of four months.
Researchers hope that in less advanced cases, the benefits could be greater.
The drug’s makers, the pharmaceutical firm Janssen, are now seeking a licence which would allow it to be used on the NHS.
More than 36,000 men are diagnosed with prostate cancer each year in the UK – more than 10,000 die from the disease.
If the disease spreads beyond the prostate, a small gland found near the bladder, then it becomes far more difficult to treat.
Abiraterone acetate interferes with the production of the hormone testosterone, which can fuel the growth of prostate cancer.
The trials involved more than 1,000 men with very advanced, aggressive cancers, whose prognosis was poor, with only months left to live.
Using novel technology allowing “virtual bone biopsies” researchers have found that a common treatment for prostate cancer called androgen deprivation therapy (ADT) is associated with structural decay of cortical and trabecular bone. The study has been accepted for publication in The Endocrine Society’s Journal of Clinical Endocrinology & Metabolism (JCEM).
Prostate cancer is the second most common cancer in men worldwide and estimates suggest there are currently 600,000 men in the United States with the condition who are being treated with ADT. Prostate cancer relies upon male hormones for its growth and ADT is a common treatment because it suppresses or blocks the production or action of male sex hormones. This is the first study to examine changes in bone structure during ADT.
A chemical found in babies’ plastic bottles may raise their odds of developing prostate cancer later in life.
In experiments, newborn rats fed bisphenol A, a building block of many commonly-used plastics, were more likely to develop pre-cancerous cells as they aged.
With chemical levels similar to those commonly found in the human body, the researchers said their findings are directly relevant to babies’ health.
Their warning comes just a week after the European food watchdog said that the amounts of the chemical we are exposed to in day-to-day life are too low to do any harm, according to the journal Reproductive Toxicology.
The Food Standards Agency also said that bisphenol A does not carry a risk but the latest study raises fresh concerns about the compound, which is also found in CD cases, tin can linings, sunglasses, plastic knives and forks, mobile phones and dental sealants, reports the Daily Mail.
American researchers showed that giving newborn rats the chemical raised their odds of developing cellular damage that can lead to prostate cancer later in life. Both mouth drops and injections were equally damaging.
University of Illinois researcher Gail Prins said: “These findings on prostate health are directly relevant to humans at current bisphenol A exposure levels.”
Bisphenol A has previously been linked to fertility problems, breast cancer, prostate cancer and heart attacks.
Campaigners say that those concerned about the chemical should use bisphenol A-free baby bottles, cut down on their use of canned foods and opt for glass, porcelain or stainless steel containers where possible.
They should also avoid heating foods, including baby meals, in polycarbonate plastic food containers – often marked with a ’7′ on the bottom – as the chemical can leak out of the plastic at high temperature.
Prostate cancer is one of the most common cancers among men and the second highest killer after lung cancer.