Experts await favourable results from phase 3 studies on advanced CRPC
Plenary session at the 1st EMUC held in November 2007
Monday, 23 November 2009- Experts are awaiting positive results from still ongoing studies on Castrate Resistant Prostate Cancer (CRPC), saying that if phase 3 studies replicate the results in earlier drug trials, patients with CRPC may yet benefit from better management options that increases drug tolerability whilst minimising adverse reactions.
"Prostate cancer management in the advanced stages of the disease consists of sequential therapy. Perhaps in the future, if there are a number of effective agents all showing efficacy for CRPC, these drugs can be used in order to keep patients free from symptoms and improve survival," said Dr. Heather Payne, consultant clinical oncologist at University College London Hospitals. Payne is slated to talk on CRPC updates at the 2nd European Multidisciplinary Meeting on Urological Cancers (EMUC) to be held this week in Barcelona, Spain.
Payne added: "This previously inconceivable concept could rapidly become a reality if these compounds continue to demonstrate the effectiveness in Phase 3 studies that have been shown in earlier trials. In this situation the tolerability, route of administration and accessibility of the drugs are going to be important factors as to the stage at which the drugs are introduced into the management plan."
She said that amongst promising new compounds are agents such as abiraterone and MDV 3100. "There have been encouraging results from studies investigating newer hormonal agents such as abiraterone and MDV 3100, immunotherapy agents such as Sipuleucel-T and new combinations of drugs with chemotherapy agents. In addition existing agents for treating other cancers are being trialled for this indication, such as Avastin," Payne explained.
Payne is also part of the ENTHUSE study which is investigating a new compound, ZD4054, a specific endothelin A receptor antagonist. Asked about the status of the ENTHUSE study, Payne replied: "We do not expect to see any results until later next year at the earliest. The ENTHUSE programme consists of three multicentre, international, randomised phase 3 studies which aim to assess the efficacy and safety of ZD4054 10mg daily verses placebo in three different clinical situations in patients with CRPC."
She said that the first ENTHUSE study follows on from a promising phase 2 trial which demonstrated a 6-7 month overall survival benefit for ZD4054 when compared to placebo in men with CRPC and bone metastases. A second study is also exploring the benefits of ZD4054 in patients with CRPC who do not have any evidence of metastatic disease. The final study investigates the safety and efficacy of ZD4054 verses placebo in addition to docetaxel chemotherapy.
"ZD4054 is a once-daily oral treatment. The safety profile we have seen to date suggests it has a good tolerability profile without the severe side effects chemotherapy can have," commented Payne.
The 2nd EMUC focuses on three key areas, one of which is prostate cancer. On Friday, November 27, sessions 1, 2 and 3 are devoted to prostate cancer and several state-of-the-art lectures will highlight the topic such as new hormonal therapies in prostate cancer (Prof. V. Ravery, Paris), controversies in prostate cancer (Prof. F. Schröder, Rotterdam), imaging techniques in the diagnosis and staging of prostate cancer, a debate on prostate cancer screening and a session on novelties in prostate cancer chaired by Prof. F. Hamdy, amongst others.
Renal cell carcinoma and bladder cancer will also be tackled with topics such as urine markers in bladder cancer screening, new systemic treatment modalities in advanced bladder cancer, the costs and benefits of new targeted agents in metastatic RCC, the role of nephrectomy in the era of targeted therapy and the latest trends in the medical treatment of urological cancers.
The European Association of Urology (EAU), the European Society for Medical Oncology (ESMO) and the European Society for Therapeutic Radiology and Oncology (ESTRO) has initiated the EMUC, a biennial gathering of cancer specialists from various disciplines, which aims to facilitate multidisciplinary approaches and optimise diagnostic, therapeutic and preventional interventions in malignant disorders in the urogenital tract.
