New drug treatment extends lives of men with prostate cancer

ScienceDaily (May 28, 2011) — A drug recently approved by the Food & Drug Administration for the treatment of prostate cancer is proving to give some patients the gift of time. A new study shows abiraterone acetate extends the lives of men with the most advanced form of the disease by about four months.

See Also:Health & MedicineProstate CancerMen's HealthPersonalized MedicineColon CancerDiseases and ConditionsProstate HealthReferenceClinical trialDouble blindUrologyMetastasis

The study in the May 26, 2011 issue of the New England Journal of Medicine was co-authored by Thomas W. Flaig, MD, medical oncologist at the University of Colorado Hospital's Tony Grampsas Urologic Oncology Clinic and assistant professor at the University of Colorado School of Medicine.

"Abiraterone acetate is a new, life-extending pill for the treatment of advanced prostate cancer. Unlike the traditional chemotherapy drugs used in these situations, abiraterone is generally very well tolerated," said Flaig.

The multi-center Phase III clinical trial of 1195 participants looked at the effectiveness of treating patients who had received prior chemotherapy with a combination of abiraterone acetate (ZytigaTM ) and prednisone. When this trial was initiated, there were no treatments that clearly prolonged survival in this late phase of prostate cancer. The patients were randomized to receive abiraterone acetate plus prednisone or a placebo plus prednisone each day. Treatment continued until the cancer progressed, there were unfavorable reactions, a new treatment was initiated or the patient withdrew from the trial.

The study shows participants taking abiraterone acetate lived about four months longer than participants taking the placebo. In addition, more patients receiving abiraterone acetate experienced a significant drop in the PSA blood level than those on the placebo.

"The survival benefit observed in this study is especially notable, since this was seen in the most advanced cases of prostate cancer," said Flaig. "Other studies are being done to examine the benefit of using abiraterone acetate earlier in the disease process, where it may be even more effective."

The FDA approved abiraterone acetate at the end of April. The tablet has few side effects but careful medical attention is required to monitor for specific potential side effects including liver blood test changes, low potassium levels, leg swelling and high blood pressure.

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Drug combination extends survival in refractory lung cancer patients, study finds

ScienceDaily (June 2, 2011) — Scientists have identified a drug combination, when used in advanced lung cancer patients, shows a survival advantage in patients who no longer respond to existing therapies. They found that bexarotene and erlotinib can each repress the critical cell cycle regulator: cyclin D1. The drug combination also broadened the reach to include a specific subset of patients, such as those resistant due to the presence of a ras mutation in their cancer.

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The study was published in the June issue of Cancer Prevention Research.

"Erlotinib has been found to be most effective in women of Asian descent who are never smokers with bronchioalveolar carcinoma, and who tend to have activating mutations of the epidermal growth factor receptor," said Ethan Dmitrovsky, M.D., an Associate Scientific Director of the Samuel Waxman Cancer Research Foundation and a senior author on the study. "None of the patients in our study fit that demographic profile."

In fact, the patients in the cohort who exhibited the greatest response included non-Asian men who were smokers. Advanced lung cancer patients with refractory disease have a survival of four months or less with traditional chemotherapy. The results of the study showed a median survival of five and a half months and longer. Three patients from the trial are now living two to four years beyond the expected average.

The study's results were recently duplicated by a group of MD Anderson scientists, noted Konstantin Dragnev, M.D., who led this trial and is an associate professor at Dartmouth Medical School, in Hanover, N.H.

The most exciting part of the research, which was funded in part by the Samuel Waxman Cancer Research Foundation, "is that scientists were able to make a dent in the ras mutation subset of patients," said Dmitrovsky, who is a professor at Dartmouth Medical School. "This area is an unmet medical need. These are often times the most difficult lung cancers to treat."

"This study gives hope to a large group of lung cancer patients who currently have very few options," said Linda Wenger, the Executive Director of Uniting Against Lung Cancer. "It's critical for nonprofit foundations to continue supporting research in underserved areas to bring new ideas to the clinic."

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Vaccine extends recurrent glioblastoma survival rates by 2 to 3 times, study finds

ScienceDaily (June 3, 2011) — In data presented at The American Society of Clinical Oncology (ASCO) Annual Meeting, cancer researchers found that the brain tumor vaccine HSPPC-96 for treating recurrent glioblastoma (GBM) has a favorable safety profile and extends survival by two to three times more than the current median survival rate.

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Patients in the study, conducted at University Hospitals Case Medical Center, University of California, San Francisco and Columbia University, were found to have a median survival of 11 months compared to current three to five month survival.

"The findings are very favorable for patients with this deadly form of brain cancer," said Andrew Sloan, MD, one of the authors of the study presented at ASCO and Director of the Brain Tumor and Neuro-Oncology Center at University Hospitals Case Medical Center. "The vaccine is one of the few immune therapies designed specifically for patients who are not newly diagnosed, and these encouraging results make this a promising therapy for a more extensive Phase 3 trial."

HSPPC-96 isolates the heat shock protein, which is part of the immune system. The protein from the patient's tumor is then reinjected into the skin with an adjuvant, or an agent added to a drug to increase its effect.

The vaccine was developed by Andrew Parsa, MD, PhD, principal investigator of the Brain Tumor Research Center at the University of California, San Francisco. He is collaborating with the Lexington, Massachusetts biotech company called Agenus. Columbia University also is part of the ongoing Phase 2 study designed to evaluate overall survival and immunologic response with HSPPC-96 in patients with first or subsequent recurrence of GBM.

All patients underwent surgery prior to vaccine therapy. However, since the vaccine is made from the patient's own tumor, the surgery had to be performed at one of the participating sites. The vaccine therapy begins within 5 weeks after surgery and consists of four weekly injections, followed by bi-weekly injections for up to 52 weeks.

"The vaccine is made from a patient's own cells, so it takes into account what is unique about the patient's particular tumor -- it's the ultimate in 'personalized medicine'," said Dr. Sloan who also is the Peter D. Cristal Chair in Neurosurgery and an Associate Professor of Neurological Surgery at Case Western Reserve University School of Medicine.

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