In the chemo-naïve stage, Sipuleucel-T and Xgeva are new options. Sipuleucel-T showed a 4-month survival gain supporting its approval. However, it is expensive and there are few PSA responses as an endpoint, he pointed out.
Denosumab inhibits RANK-ligand and compared to Zometa it was superior with an 18% risk reduction in the first skeletal related event. It is given sub-cutaneously and hypocalcemia and osteonecrosis of the jaw are potential complications. It is expected that in CRPC, Denosumab will be reported to have a 4.2-month bone metastasis-free survival advantage.
Docetaxel is being evaluated with a variety of agents. Combination with Atrasentan in a SWOG trial has just been found to be negative.
OGX-011 is in phase III currently. Cabazitaxel was superior to mitoxantrone in the post-chemo failure setting and is also approved.
Abiraterone is recently approved for CRPC therapy and inhibits CYP17 to decrease androgen production. It is anticipated that abiraterone will be evaluated in the pre-chemotherapy setting as well. MDV3100 is in Phase III. It is a 2nd generation anti-androgen and is being evaluated in the pre- and post–chemotherapy setting.
Presented by Martin Gleave, MD at the Society for Basic Urologic Research (SBUR)/Society of Urologic Oncology (SUO) joint meeting during the American Urological Association (AUA) Annual Meeting - May 14 - 19, 2011 - Walter E. Washington Convention Center, Washington, DC USA
Reported for UroToday by Christopher P. Evans, MD, FACS, Professor and Chairman, Department of Urology, University of California, Davis, School of Medicine.