It has always been assumed that Ketoconazole, when used for the treatment of men with metastatic castration resistant prostate cancer (mCRPC), would not be as potent as abiraterone (Zytiga), but there has never been any head to head comparison to demonstrate this assumption! Ketoconazole is a less potent inhibitor of the CYP-17 enzyme, the mode [...]
There is some really good news for those of us who live in areas where The National Institute for Health and Care Excellence (NICE) recommends drug approvals. NICE has issued a final draft guidance recommending that men with hormone-relapsed prostate cancer (castrate resistant) that has metastasized and has been treated with docetaxel (chemotherapy) should be [...]
The explosion of new therapies for men with metastatic castration resistant prostate cancer (mCRPC) raises serious questions about the optimal sequencing of these new treatments as well as whether cross-resistance occurs between these drugs. It was recently reported that chemotherapy with docetaxel (D) is not effective in in men who did not have a ? [...]
Some of my posts over the last week or two have discussed the issue of the development of cross-resistance of two of our newest treatments for advanced prostate cancer. These drugs are abiraterone (Zytiga) and enzalutamide (Xtandi). Currently, both of them are approved for use after a man has failed chemotherapy with docetaxel. In addition, [...]
On March 4, 2014 I wrote a post “Castrate Resistant Prostate Cancer- What to Do Next” (www.advancedprostatecancer.net/?p=4425). The basic theme of the post was about how difficult it is to know how to sequence the new drugs we have to treat advanced prostate cancer (metastatic castrate resistant prostate cancer aka mCRPC). In the post I [...]
Confusion, confusion and more confusion, that is how I would describe the current decision making process for a man with prostate cancer that has become newly castrate resistant. Just a few years ago the decision tree was clear, castrate resistant, immediately on to chemotherapy with docetaxel. Today, in this treatment space, we have a number [...]
Some men with advanced prostate cancer have been given the antifungal treatment Ketoconazole (Keto) as a second line hormone treatment. Like Keto, this newer hormone treatment that is now available, Abiraterone acetate (AA) (Zytiga) works by inhibiting CYP17, the rate-limiting enzyme in androgen biosynthesis. The question being asked, if Keto has failed ,given its similar [...]
Since its FDA approval in 2011 FDA abiraterone (Zytiga) has supplanted docetaxel (chemotherapy), other than perhaps Provenge, as preferred first-line treatment for metastatic castrate-resistant prostate cancer. August 2012 saw the FDA approval of enzalutamide (Xtandi) for the treatment of castrate-resistant prostate cancer after chemotherapy. Researchers performed a retrospective chart review at a large medical oncology [...]
Men with metastatic castration-resistant prostate cancer (mCRPC) in Québec, Canada now have access to Zytiga (abiraterone acetate) prior to having chemotherapy. Effective February 3, 2014, the province has added ZYTIGA to the public drug formulary for the treatment of mCRPC in men who are asymptomatic or mildly symptomatic after failure of androgen deprivation therapy (ADT). [...]
After a great deal of confusion and what turned out to be an error on my part I wish to let you know that the NICE (The U.K.’s National Institute for Health and Care Excellence) Guidance I shared on the blog on January 28, 2014 (http://advancedprostatecancer.net/?p=4360 ) about enzalutamide (Xtandi) was not accurate. In my [...]
