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Promising--yet preliminary--results from an early clinical trial show
that the experimental drug abiraterone can significantly reduce the
size of prostate cancer tumors in men who haven't responded to other
therapies.
Researchers from the Royal Marsden NHS Foundation Trust and
the Institute of Cancer Research in the United Kingdom recruited 21 men
with late-stage prostate cancer who were no longer responding to
hormone therapy and prescribed a once-a-day regimen of the pill
abiraterone.
After taking the drug, 70% to 80% of the men showed lower
prostate-specific antigen (PSA) levels and tumor shrinkage. Disease
progression was delayed by a median of 400 days. Side effects, which
included high blood pressure, weight gain and fatigue, were minimal.
While these are impressive results for an early clinical
trial, abiraterone is not yet approved for use by the US Food and Drug
Administration, so it isn't available outside of clinical trials. And
experts caution that the drug's approval isn't a foregone conclusion.
"All of us in cancer care have seen reports of promising
results showing a small number of patients surviving a long time, and
once the drug has entered into a randomized trial against a placebo or
the current standard of care, the results show no real difference,"
said Otis Brawley, MD, Chief Medical Officer of the American Cancer
Society.
And although the PSA test is often an indicator of tumor
activity, it doesn't give the whole picture. Prostate-specific antigen
is a protein produced by prostate cells. When the prostate enlarges or
when there's a tumor in the gland, PSA levels often increase.
"A PSA decline or tumor shrinkage are only evidence of
activity, and activity only means there's a need for a good randomized
trial. The bottom line for patients and the public is we need a
randomized trial showing longer survival time or improved quality of
life as the endpoint," said Brawley.
The drug, which is manufactured by Cougar Biotechnology, Inc,
works by blocking the enzyme CYP17, which plays a role in hormone
production and tumor growth. Researchers say they will soon be
reporting results of a phase II study and are planning phase III
studies. They hope the drug can be on the market in 2011.
More than 186,320 new cases of prostate cancer will be
diagnosed, and 28,660 men in the United States will die of prostate
cancer this year, according to Cancer Facts and Figures
2007-2008. For more information on prostate cancer and its
treatment, see Detailed Guide: Prostate Cancer.
Citation: "Phase I Clinical Trial of a Selective Inhibitor of CYP17,
Abiraterone Acetate, Confirms That Castration-Resistant Prostate Cancer
Commonly Remains Hormone Driven." Published online July 21, 2008 in the
Journal of Clinical Oncology. First author: Johann
S. de Bono, MB ChB, FRCP, MSc, PhD. Royal Marsden NHS Foundation Trust
and the Institute of Cancer Research, United Kingdom.
ACS News Center stories are provided as a source of cancer-related
news and are not intended to be used as
press releases.
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