In my commitment to report “On the Horizon” treatments for advanced prostate cancer today I will discuss an investigational treatment known as Tasquinimod. It is an experimental treatment that is both an immunotherapy and anti-angiogenic agent (designed to prevent the development of blood vesicles which would feed a tumor allowing its growth). In phase 2 clinical trials it has shown its ability to prolong progression-free survival (PFS) and also overall survival (OS) in certain men with metastatic castration-resistant prostate cancer (mCRPC).

Researcher at Duke University reported that in more than 2 years men who participated in the randomized, placebo-controlled trial experienced improved PFS on tasquinimod. Additionally, they reported that in a second generation version of the oral quinoline-3-carboxamide analog had also resulted in improvements in OS. These results appeared in the journal Clinical Cancer Research.1

In the study, 201 men with minimally symptomatic, metastatic CRPC were assigned in a 2:1 ratio to tasquinimod or placebo. OS results were evaluated after 111 deaths.

Median OS was 33.4 months in the tasquinimod group versus 30.4 months for those taking placebo. Researchers also reported that the results were best for the subgroup of 136 men in the study who had bone metastases; they experienced a 34.2 month OS as compared to 27.1 months for those who took placebo.

PFS lasted an average 7.6 months for men taking tasquinimod, as compared with 3.3 months for those on placebo; among men with bone metastases, those numbers rose to 8.4 months in the experimental group versus 3.4 months in the control group, Duke reported in an announcement about the findings.2

Toxicities from the tasquinimod were described as mild, with improvements occurring over time. Symptoms included mild gastrointestinal problems, pains in muscles and joints, and fatigue.

The team conducted exploratory biomarker studies at baseline and throughout the study to help identify predictors of benefit with tasquinimod.

Based on those findings, tasquinimod is being tested in a phase III trial in men with CPRC and bone metastases. According to Duke, it is likely the drug will also be tested in other cancers.

It is always good to see potential new drugs under development having positive results, but like our many other treatments survival advantages are measured in just a few months. I don’t know about you, but I am increasingly becoming cranky, the time has come to begin to have drugs that will have an extended impact on our survival. Three or four months are good, but what about three or four years?

1. Armstrong AJ, Haggman M, Stadler WM, et al. Long-term survival and biomarker correlates of tasquinimod efficacy in a multicenter randomized study of men with minimally symptomatic metastatic castration-resistant prostate cancer. Clinical Cancer Research. Published online ahead of print, November 13, 2013.
2. Duke Medicine. Oral Drug May Improve Survival in Men with Metastatic Prostate Cancer. DukeHealth.org. http://tinyurl.com/nw4pj2b. Published November 13, 2013. Accessed November 26, 2013.

http://www.onclive.com/publications/urologists-in-cancer-care/2013/December-2013/Tasquinimod-Improves-OS-PFS-in-CRPC-Data-Show#sthash.CGXtUqp3.dpuf

Joel T. Nowak, M.A., M.S.W.