Tuesday, September 2, 2008

Abiraterone and prostate cancer

One drug that has been tearing up the newsfeed this year is abiraterone, a novel drug in phase II trials for prostate cancer.

In February, data was presented at ASCO's Genito-urinary satellite meeting that looked promising. Dr D.C. Danila and researchers from Memorial Sloan Kettering reported a small phase II trial in castration resistant metastatic prostate cancer after failure of docetaxel therapy.

They looked at abiraterone acetate (AA), an oral and irreversible inhibitor of CYP17 that decreases testosterone and DHT levels to undetectable. The study sought to determine the proportion of patients achieving a PSA decline of >50% and to assess toxicity. It was a multicenter trial using abiraterone 1000mg orally daily and prednisone 5mg daily. Successful abiraterone activity was defined as a PSA decline >50% in >30% of patients. It was defined as not successful if the PSA decline occurred in <10%>50% PSA decline. Radiological assessment was possible in 26 men who had at least 3 cycles of treatment. No decreases in bone metastasis by bone scans were noted, but some had unchanged bone scans. The addition of prednisone reduced the frequency of adverse events. Circulating tumor cells (CTCs) was used as an additional means to asses response to treatment and did correlate with PSA changes.

A total of >5 CTCs prior to treatment that decreased to <3 (link) - including more details on the company developing the agent.

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