FROM THE 2006 ASCO/ASTRO/SUO/PCF Part 4

[Guest guest]

From Merel Nissenberg http://www.naspcc.com Please share with anyone who

might be interested.

Day Three:

Optimizing Systemic Therapy for Prostate Cancer: Dr. Dreicer also

of the Cleveland Clinic discussed hormonal therapy as monotherapy. There

has been a large increase in the use of ADT, especially early use of

such therapy. He stated that cure is not a goal but rather possible

improvement in survival and a drive to lessen/delay the morbidity

associated with the disease. Dr. Dreicer stressed that hormonal therapy

is NOT benign and we need to consider alternative strategies to

continuous testicular suppression. He suggested increased monitoring of

serum testosterone levels.

Dr. Cora Sternberg of San Camillo and Florlanini Hospitals in Rome

described when and how to treat with chemotherapy for hormone-refractory

disease. She stated that both TAX 327 and SWOG 9916 demonstrated that a

docetaxel regimen can reduce the risk of death by 20-24%. She also

mentioned the SPARC trial underway which will compare satraplatin plus

prednisone to prednisone alone. However, there are no trials regarding

the timing of chemotherapy. She recommended chemo if the patient is

asymptomatic with extensive metastases or symptomatic with mets.

Intermittent chemo may also address toxicity concerns. Finally, Dr.

Hussain discussed several new agents in clinical trials, addressing such

targets as DNA, VEGF, histones, EGFR and HER-2, and the endothelin

receptor. This last target is being studied in a clinical trial

involving Atrasentan.

Novel Targets and Approaches: Dr. Small of UCSF presented a talk on

the rationale for Immunotherapy in prostate cancer. He discussed G-VAX,

Provenge and CTLA-4 Blockade-based Immunotherapy, all of which have

exciting possibilities. He stated that the overall survival benefit seen

with Provenge seemed to be significant. There were other papers covering

other targets arising out of epigenetics and modification of proteins.

EGFR and HER-2 were discussed as potential therapeutic targets.

ASCO Special Lectureship - by Dr. Coffey: In his own inimitable

way, Dr. Coffey's presentation was provocative and asked WHY some

treatments work - citing Lance Armstrong as an example. The talk

included self-organization, chaos and how hyperthermia increases the

effect of chemotherapy and radiation. He said that cancer cells are

sensitive to heat and are killed by heat before normal cells. If you

direct the hyperthermia directly to the tumor, you can enhance

immunology, RT and chemotherapy.

Measuring Outcomes: Finally, there were presentations on PSA as a

surrogate marker, using the Prentice Criteria - which must meet four

statistical tests. There was also advice

on how to get a drug through the FDA - citing the fact that docetaxel

plus prednisone was approved for patients with hormone-refractory

metastatic prostate cancer based upon the fact that there was an

improvement in survival compared to mitoxantrone plus prednisone.

All in all, the 2006 Prostate Cancer Symposium was an

exciting and informative meeting, with many exciting possibilities on

the frontier. We look forward to the 2007 meeting!

Kathy Meade

Arlington Educational Consulting

http://www.vapcacoalition.org/

http://www.naspcc.org/

phone

fax

Anyone can be passionate, but it takes real lovers to be silly. ~Rose

en