Zytiga (abiraterone acetate) and Ketoconazole (keto) are both widely used in prostate cancer therapy to treat men with advanced prostate cancer. They both have a common mechanism of action, they both work by inhibiting the enzyme CYP17 that is responsible for androgen biosynthesis (creation). Inhibiting CYP17 lowers testosterone levels, which results in prostate cancer tumor regression. Because [...]
On the advanced prostate cancer online support group there have been some questions raised about how we know when drugs like Zytiga and Xtandi have stopped working. Knowing this as soon as possible is important so that you can quickly move on to the next treatment without giving the prostate cancer time to progress and [...]
The first line of treatment for advanced prostate cancer is Androgen (male hormone) Deprivation Therapy or ADT. Once the PSA progresses (climbs) while still on ADT and with testosterone levels
On August 13, 2013 I wrote an important post about the terrible practice beginning to rear its head called step therapy. Step therapy is the practice of insurance companies requiring less expensive drugs be prescribed prior to more expensive ones despite the comparative efficacy of the drugs and their different mechanisms of action. This practice [...]
Since it FDA approval in 2004, docetaxel (a taxane based chemotherapy) has been the standard first-line chemotherapy for men with metastatic prostate cancer (mCRPC). Other than the trial of Provenge all the successful phase III trials conducted in mCRPC focused on men experiencing cancer progression after first-line docetaxel chemotherapy. The implication is that improving the [...]
There was a lot of interesting and important presentations at the recent American Urological Association meeting, however the one item that will have the most impact on men with advanced prostate cancer is the new guidelines that were proposed for the treatment of men with castrate resistant prostate cancer. The guidelines were organized by creating [...]
I don’t understand why if I have hormone resistant advanced prostate cancer why the new drugs, Zytiga and Xtandi work. These drugs are still hormone therapies, is my prostate cancer hormone resistant? I recently received an email asking me this question and I thought it might be a question many people have, so I am [...]
At the recent 2013 2013 Genitourinary Cancers Symposium there was an abstract presented that updated data from the COU-AA-302 clinical trial of Abiraterone Acetate (Zytiga) with prednisone. The updated data confirms that Zytiga with prednisone improves overall survival (OS) in men with metastatic castrate resistant prostate cancer (mCRPC) post-docetaxel therapy (chemotherapy)(Lancet Oncol 2012;13:983-92). The trial [...]
Currently in Orlando Florida the 2013 American Society of Clinical Oncology (ASCO) Genitourinary Cancers Symposium is in progress. There are a number of very interesting abstracts that pertain to those of us who have advanced prostate cancer. In the course of the next few days I will be reviewing a number of these that I [...]
I have said many times that one of the more important issues facing our use of Provenge is when to start it and how to sequence this treatment with the other newly approved agents that have recently become available for men with advanced prostate cancer. There is occasional conversation that Provenge is already antiquated due [...]
