Announcing an Educational Webinar About Erleada

Jansen Pharmaceuticals has requested that we let our blog readers know about an upcoming educational webinar they are sponsoring on Tuesday, 9/18/18, 7 p.m. ET.  The webinar will be discussing their newly approved treatment, apalutamide (Erleada) which is approved by the FDA for men with castrate resistant, non-metastatic prostate cancer, sometimes referred to as M0 (M-zero) disease.  

Lynparza with Zytiga Improves Outcomes

Recently presented data has shown that there is a clinical improvement in median radiologic progression-free survival (rPFS) when olaparib (Lynparza) is used in combination with abiraterone (ZYTIGA) compared to abiraterone alone in men with metastatic castration-resistant prostate cancer (mCRPC). 

Does Hormone Therapy (ADT) Work?

Through the work of Huggins et al. [1] in 1941, it was shown that metastatic prostate cancer responds positively to an orchiectomy (surgical castration). We now know that there isn’t any other therapy which produces a more reliable regression of both distant and local disease than androgen withdrawal (ADT). 

Pembrolizumab is Effective in Some Men with Untreatable Advanced Prostate Cancer

In a recent study of 258 men with otherwise untreatable castrate resistant prostate cancer the immunotherapy drug Pembrolizumab showed that it was able to control the disease having a positive response lasting six months or more in 11 percent of men, with two men showing a complete response.

Xofigo (Radium-223) - Cautionary Information

The European Medicines Agency (EMA) has recommended that the use of Xofigo (Radium-223) be restricted.  The restrictions, because of safety and efficacy concerns in men with castrate resistant prostate cancer (mCRPC), include that Xofigo can be used only after two other treatments have been taken; when other therapies cannot be used and not in combination with other 2nd line hormone therapies. 

AR-V7 Liquid Biopsy Coming of Age

Once a man is castrate resistant and moves on a second line hormone therapy drug like Zytiga or Xtandi (aka AR inhibitors) it is inevitable that the Zytiga or Xtandi will also become ineffective.  

When this happens, the question that comes is what should be the next treatment?  Generally, the options currently available are either to move to the drug not initially used ( Zytiga if Xtandi was first used or Xtandi if Zytiga was used) or instead to use taxane chemotherapy (Taxotere aka docetaxel).  

First Line Treatment for Newly Diagnosed Metastatic Prostate Cancer

Initially being diagnosed with metastatic, or advanced prostate cancer is not great.  Metastatic prostate cancer is not curable and will be terminal if you don’t die from another cause.  

We now have a number of what we consider second-line treatments for prostate cancer, drugs like Zytiga, Xtandi and Taxotere (chemotherapy).  

We are beginning to recognize the value of the early use of these second line drugs along with first line ADT for men who are initially diagnosed with metastatic prostate cancer.  

Abiraterone or Docetaxel? 

Since the approvals for the early use of docetaxel chemotherapy (Taxotere) and the early use of abiraterone acetate (Zytiga) there is no clear evidence demonstrating which of these two agents should be used for men with hormone sensitive, newly diagnosed, aggressive prostate cancer. 

A Subtype of Prostate Cancer Identified Along with A Possible Therapy

A newly identified subtype of prostate cancer characterized by the loss of the gene CDK12 was found to be more common in men with metastatic prostate cancer compared to non-metastatic disease. What makes this discovery very important is that prostate cancer with the inactivation or loss of the CDK12 gene seems to be responsive to checkpoint inhibitors. 

African American Men Might Have a Survival Advantage Over Caucasian Men!

In a surprising analysis it was determined that the overall survival (OS) between African American and Caucasian men with metastatic castration-resistant prostate cancer (mCRPC) favors African Americans!