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!

177Lu-PSMA-617 Clinical Trials

Endocyte, Inc. announced that it has enrolled the first man into its phase 3 VISION study of 177Lu-PSMA-617 as a clinical therapy.  Cancer ABCs has had a number of men asking about the trial.

VISION is an open-label, randomized trial assessing the addition of radiolabeled prostate-specific membrane antigen to standard therapy for PSMA-positive, previously treated metastatic castration-resistant prostate cancer (mCRPC). The study will enroll 750 men in total, with the primary endpoint being overall survival.

Currently, there are six different trials evaluating 177Lu-PSMA-617 actively recruiting men worldwide.  In the United States they are at Weill Cornell Medical Center in New York, UCLA in Los Angles, and one site in Houston Texas.  There are also trials in multiple locations in the UK, in Italy and in Australia.  For additional trial information and locations go to 

https://clinicaltrials.gov/ct2/results?term=177Lu-PSMA-617&Search=Search

Joel T. Nowak, MA, MSW wrote this Post.  Joel is the CEO/Executive Director of Cancer ABCs.  He is a Cancer Thriver diagnosed with five primary cancers - Thyroid, Metastatic Prostate, Renal, Melanoma, and the rare cancer Appendiceal cancer.

 

Provenge and Clinical Outcomes by Baseline PSA Level

Provenge (Sipuleucel-T) is the first FDA approved cancer vaccine and it is still the only immune therapy approved for Prostate Cancer. In a post-hoc analysis it was demonstrated that those men who have lower PSA scores had a superior overall survival. The analysis also showed that men who had Provenge treatment have a lower risk of cardiovascular events.

Young Men with Appendicitis Have A Nine Fold Increased Risk for Developing Lethal Prostate Cancer

Researchers have recently found that men under the age of 20 years who have an appendicitis are up to nine times more likely to develop prostate cancer later in life.  The study that came to this conclusion was performed by scientists at Orebro University in Sweden.  It is one of the first to highlight this increase in the risk for the development of prostate cancer.  

Treatments for Advanced Prostate Cancer May Work Better in Black Men

Black men are more likely to be diagnosed with prostate cancer at a younger age, with an advanced stage, and with a higher grade. Black men are also twice as likely to die from prostate cancer than white men. Despite these facts, these two studies show that certain treatments for advanced metastatic prostate cancer may work better in black men. 

A Generic Version of Zytiga Has Been Approved by the FDA

The U.S. Food and Drug Administration (FDA) has approved a generic version of Zytiga, the new drug’s name is Yonsa.  It is a novel formulation of abiraterone acetate that needs to be used in combination with methylprednisolone for the treatment of men with metastatic castration-resistant prostate cancer (mCRPC).

Cancer Insurance & Family Leave News

There are a number of items including Medicaid Expansion (or the lack of it), Family Leave and the latest attempt by certain states to screw people with pre-existing and serious chronic illness despite the federal laws protecting our medical insurance.

Statin Use Along with Zytiga or Xtandi Extends Survival in Men Who Failed Chemotherapy 

Statins have been in the prostate cancer news feeds for a long time.  They are believed to potentiate the effects of the anti-hormonal agents used to treat metastatic castration-resistant prostate cancer (mCRPC). Different stages of prostate cancer as well as different treatment exposures might change the efficacy of statins.