A New Agent That Might Change the Lives of Many Cancer Patients

This is not only good news for all prostate cancer patients, but is also good news for all cancer patients. 

The investigational radiopharmaceutical radium-223 chloride (Alpharadin) has recently been shown to improve survival in patients with advanced prostate cancer and bone metastases.  This agent could potentially be used in other cancer patients to extend their lives. 

The beauty of this product is that it is highly targeted for bone metastases; so this product will be valuable for many different Stage IV cancers patients whose cancers have spread to bones. 

Radium-223 chloride works by releasing minute, highly charged, targeted doses of radiation (alpha particles) that are highly lethal to cancer cancers but have a short penetration.  This specific targeting delivers radiation to the bone metastases and minimizes the damage done elsewhere. 

Docetaxel (Taxotere) is Effective in Heavily Pretreated Nasopharyngeal Carcinoma Patients

It is well-established that nasopharyngeal carcinoma (NPC) is a chemo-responsive disease.  Despite improved outcome with chemo-radiation (platimum-based chemotherapy with radiation), treatment failure continue to be a problem in patients with locally advanced Stage III/IV disease. 

Now, a new study published in the Annals of Oncology suggested that nasopharyngeal cancer patients who have failed platinum-based chemotherapy (such as oxaliplatin-Eloxatin) have another treatment option. 

Thirty patients with confirmed metastatic or recurrent NPC who have failed at least one line of palliative chemotherapy regimen were given weekly docetaxel every 28 days and were evaluated for responses. 

Novel Agent Significantly Improves Survival in Men with Advanced Prostate Cancer

Great news for patients with advanced prostate cancer.  A new investigational agent, abiraterone acetate, was shown to significantly improved survival in men with metastatic castration-resistant prostate cancer. 

Abiraterone acetate is an investigational agent being developed by Ortho Biotech.  It acts by blocking CYP17 and potently inhibits persistent androgen synthesis from adrenal and intratumoral sources. 

In the study, investigators randomly assigned 1,195 patients with castration-resistant metastatic prostate cancer and who had been previously treated with docetaxel to 1 of 2 study groups: abiraterone 1000 mg plus prednisone 5 mg twice daily (n = 797) or placebo plus prednisone (n = 398). 

Patients who received abiraterone acetate plus prednisone had a median overall survival of 14.8 months, compared with 10.9 months for patients assigned to receive corticosteroid prednisone plus placebo. 

The most commonly observed adverse effects in the abiraterone group were fluid retention (30.5% vs 22.3%) and hypokalemia (17.1% vs 8.4%).  Grade 3/4 hypokalemia (3.8% vs 0.8%) and grade 3/4 hypertension (1.3% vs 0.3%) were infrequent. 

While 3.9 months may not seem like much in the history of prostate cancer, only 4 drugs have ever shown a survival benefit.  Furthermore, it is an oral that does not have the toxicity of chemotherapy.  

It is anticipated that this new drug will change the way doctors treat advanced prostate cancer in the future. 

Source: 35th European Society for Medical Oncology Congress: Abstract LBA5. Presented October 11, 2010.

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Another Option in the Second Line Treatment of Patients with Advanced Non-Small-Cell Lung Cancer (NSCLC)

Docetaxel(Taxotere) has long been considered the standard of care for second-line treatment of advanced NSCLC.  However, the disadvantage of using this agent include the need to administer it with corticosteroid premedication and its toxicity profile

A new study published in the March 29 version of the Journal of Clinical Oncology indicated that vinflunine(Javlor) was as efficacious as docetaxel in treating patients with advanced non-small-cell lung cancer (NSCLC).  Even though vinflunine had higher rates of certain side effects, the drug’s overall toxicity profile was manageable.

The study randomized 551 patients with stage III/IV NSCLC who had progressive disease after first-line therapy with a platinum-containing regimen to receive either vinflunine or docetaxel until disease progression or toxicity.

Median progression-free survival was 2.3 months in both the vinflunine and docetaxel arms while the median overall survival rates were 6.7 and 7.2 months with vinflunine and docetaxel, respectively.

Quality-of-life scores which included the percentage of patients who used analgesics during treatment and treatment compliance were also similar in the two groups.

Adverse effects such as injection-site reactions, abdominal pain, neutropenia, leukopenia, constipation, vomiting or alopecia, however, were observed more frequently with the vinflunine group.

Nonetheless, the investigator suggested that vinflunine may be another option to docetaxel in the 2^nd treatment of patients with advanced NSCLC since most of the adverse effects observed with vinflunine were manageable.

J Clin Oncol 2010.

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