Dana-Farber Cancer Institute, Boston, MA Tulane Cancer Center, New Orleans, LA.

Ketoconazole is a commonly used secondary hormonal therapy in castration-refractory prostate cancer (CRPC), but disease progression inevitably occurs. Both prostatic and metastatic lesions in patients with CRPC overexpress 5-alpha reductase (SRDA5) type I. We hypothesized that SRDA5 inhibition in combination with ketoconazole would mitigate progression after treatment with ketoconazole alone.

A total of 10 patients with CRPC with progression after ketoconazole treatment were treated with a combination of ketoconazole plus dutasteride 0.5 mg/day, a dual SRDA5 inhibitor.

After dutasteride addition, 8 (80%) of the 10 patients had varying degrees of prostate-specific antigen (PSA) decline relative to baseline. Median progression-free survival after dutasteride addition was 4.9 months (range, 2.7+ to 9.8 months); no patient had a >/= 50% PSA decline.

We conclude that dutasteride added to ketoconazole at the time progression might prolong time to PSA progression in patients with CRPC.

Written by:
Sartor O, Nakabayashi M, Taplin ME, Ross RW, Kantoff PW, Balk SP, Oh WK.   Are you the author?

Reference:
Clin Genitourin Cancer. 2009 Oct 1;7(3):E90-E92.

PubMed Abstract
PMID:19815488

UroToday.com Prostate Cancer Section

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