Post by Allen on Jul 29, 2014 20:41:54 GMT -8
Angiogenesis inhibitors
These drugs prevent the tumor from creating its own blood supply. Thalidomide is the oldest drug of this class, and a newer version, called lenalidomide (Revlimid) may possibly be more effective or have fewer sides. The hot new one in this category, tasquinimod, is in Phase III clinical trials (NCT01234311 & NCT00560482). In men who had mCRPC, were minimally symptomatic and had bone mets, tasquinimod lengthened survival to a median of 34 months vs 27 months with placebo:
Long-term survival and biomarker correlates of tasquinimod efficacy in a multicenter randomized study of men with minimally symptomatic metastatic castration-resistant prostate cancer.
It is also being tried in clinical trials in combination with Jevtana, and with Provenge. A previous angiogenesis inhibitor, bevacizumab (Avastin), did not prolong survival for PC and was disapproved by the FDA for breast cancer.
This is a good review article on the subject: VEGF Inhibitors and Prostate Cancer Therapy
While we wait for tasquinimod results and approval, it may be possible to use lenalidomide or thalidomide. They don’t seem to have much anti-PC activity on their own, but may work best in combination with chemo.
Lenalidomide monotherapy in chemotherapy-naive, castration-resistant prostate cancer patients: final results of a phase II study.
Lenalidomide enhances the anti-prostate cancer activity of docetaxel in vitro and in vivo.
Dual antiangiogenic therapy using lenalidomide and bevacizumab with docetaxel and prednisone in patients with metastatic castration-resistant prostate cancer (mCRPC).
The efficacy and safety of docetaxel plus thalidomide vs. docetaxel alone in patients with androgen-independent prostate cancer: a systematic review.
Safety
These drugs will make one very sleepy (thalidomide was originally sold as a sedative), which can be a good thing if hot flashes keep one awake. Blood must be monitored for neutropenia and thrombocytopenia. There is an increased danger of thromboembolism, so it may be prudent to take aspirin with it.
These drugs prevent the tumor from creating its own blood supply. Thalidomide is the oldest drug of this class, and a newer version, called lenalidomide (Revlimid) may possibly be more effective or have fewer sides. The hot new one in this category, tasquinimod, is in Phase III clinical trials (NCT01234311 & NCT00560482). In men who had mCRPC, were minimally symptomatic and had bone mets, tasquinimod lengthened survival to a median of 34 months vs 27 months with placebo:
Long-term survival and biomarker correlates of tasquinimod efficacy in a multicenter randomized study of men with minimally symptomatic metastatic castration-resistant prostate cancer.
It is also being tried in clinical trials in combination with Jevtana, and with Provenge. A previous angiogenesis inhibitor, bevacizumab (Avastin), did not prolong survival for PC and was disapproved by the FDA for breast cancer.
This is a good review article on the subject: VEGF Inhibitors and Prostate Cancer Therapy
While we wait for tasquinimod results and approval, it may be possible to use lenalidomide or thalidomide. They don’t seem to have much anti-PC activity on their own, but may work best in combination with chemo.
Lenalidomide monotherapy in chemotherapy-naive, castration-resistant prostate cancer patients: final results of a phase II study.
Lenalidomide enhances the anti-prostate cancer activity of docetaxel in vitro and in vivo.
Dual antiangiogenic therapy using lenalidomide and bevacizumab with docetaxel and prednisone in patients with metastatic castration-resistant prostate cancer (mCRPC).
The efficacy and safety of docetaxel plus thalidomide vs. docetaxel alone in patients with androgen-independent prostate cancer: a systematic review.
Safety
These drugs will make one very sleepy (thalidomide was originally sold as a sedative), which can be a good thing if hot flashes keep one awake. Blood must be monitored for neutropenia and thrombocytopenia. There is an increased danger of thromboembolism, so it may be prudent to take aspirin with it.