Prostate cancer (PRCA) is really (at least) two different diseases. The most common form sometimes called the kitty cat form, is by far the most common, and the least harmful. Most men who have this type will eventually die from something other than the cancer.
On the other hand, the aggressive tiger form is much less common, but has a far different outcome. It typically spreads locally outside the prostate gland capsule, and then to the bones, and patients often die a very painful death. PRCA is among the most commonly diagnosed cancer, thanks to the PSA blood test, but it is most often the indolent (kitty cat) variety, not nearly as lethal as many other cancers (such as lung, pancreatic, kidney, etc.). Even so, about 30,000 Americans die of PRCA each year.
Chemotherapeutic treatment of the aggressive form is, at best, modestly effective. But thanks to Medivation Inc., a drug called Xtandi already used to treat metastatic prostate cancer after chemotherapy may actually be more useful before (or in place of) chemotherapy.
In a randomized clinical trial consisting of 1,700 men who had failed to derive any benefit from hormone deprivation therapy another suboptimal treatment that blocks male hormones (androgens) from feeding the prostate cancer cells Xtandi showed some impressive results. The drug reduced the risk of death by 29 percent and the risk of progressive disease prior to death by 81 percent when compared to placebo.
One of the authors of the study (the PREVAIL study), Dr. Tomasz Beer, director of the Knight Cancer Institute at Oregon Health and Science University said An 81 percent reduction in risk of progression is really quite remarkable in prostate cancer. This is the most exciting thing to have a result like this that's unambiguously positive and offers patients a new treatment option that's well-tolerated, extends life and controls the disease."
Additionally, Xtandi extended the time that men with metastatic prostate cancer were able to delay chemotherapy by 28 months, vs. 10.8 months for placebo. And the drug is virtually side-effect free, as evidenced by the discontinuation rate 6 percent from both the drug treated and placebo groups.
Perhaps more impressive is that the median time to disease worsening was 3.9 months in the placebo group and had still not been reached in the drug-treated group at the time these data were collected.
ACSH s Dr. Gilbert Ross says, This is a very welcome development in the battle against metastatic prostate cancer. When the disease spreads, the prognosis is very poor, and the symptoms of the disease are awful. Any drug that can delay the onset of the disease progression while still not a cure is a very welcome option for men afflicted by aggressive prostate cancer, an especially painful and debilitating type of cancer.
