A study which was funded by Cell Pathways Inc., developer of the drug Exisulind, suggest that Exisulind may delay disease progression in men with recurrent prostate cancer according to Dr. Erik Goluboff, Assistant Professor of Urology at Columbia University College of Physicians & Surgeons, Director of Urology at The Allen Pavilion of New York-Presbyterian Hospital, and the principal investigator of the trial. He said, “This will subsequently prolong the time period between post-surgical PSA rise and the need for androgen deprivation therapies.”

Exisulind is a class of drug called selective apoptotic anti-neoplastic drugs (SAANDs). They inhibit cyclic GMP phosphodiesterase and selectively induce apoptosis (programmed cell death) in abnormally growing pre-cancerous and cancerous cells. SAANDs do not induce apoptosis in normal cells, so they do not produce the morbidity issues normally associated with chemotherapeutic and hormone blocking agents that are used to treat prostate cancer.

SAANDs will delay the need for hormone therapy along with the side effects created by hormonal treatment.

In mice studies Exisulind inhibits the growth of prostate cancer by 80 percent to 90 percent. In a related study using men, researchers found that the drug also causes regression in the growth of precancerous colonic polyps, a condition that often leads to colon cancer.

For 12 months, the trial enlisted 96 prostate cancer survivors post prostate surgery. All had rising prostate-specific antigen (PSA) levels indicating recurrent disease. Half received Exisulind, and half were given a placebo. Over a twelve-month period the researchers measured the drug’s ability to slow or halt disease progression by following patients’ PSA levels.

Additionally, imaging tests were performed before and after the study. All of the men were classified into risk groups with no statistical difference in age, race, and weight. The study showed a significant decrease in the rate of rise in PSA in patients given Exisulind compared with placebo.

Longer-term studies along with a larger sample must be performed before we can make any statements about Exisulind. However, it seems to hold promise to help control our disease without adding additional costs on our quality of life.

Joel T. Nowak, MA, MSW