European Multidisciplinary Cancer Congress (EMCC) 2011, 23-27 September, Stockholm

Prostate cancer drug development update

Professor Cora Sternberg – San Camillo and Forlanini Hospitals, Rome, Italy


A lot of interesting data coming up and you’re interested in a variety of the non-obvious effects in prostate cancer patients. There’s some nice clear survival data FDA have approved.

And EMA also, last week, just last week.

OK, so that’s good news for prostate cancer patients.

Yes, there have been updated survival curves since the New England publication as well, showing an even longer median survival than what was originally presented at the interim analysis.

The updated survival data for the abiraterone?

The updated survival data were presented at ASCO by Howard Scher with a 20 month follow-up showing an increase in the median from 3.9 to 4.6 months. So the data really looking good and the patients that I have in treatment for some two to three years are doing extremely well with an extremely non-toxic hormonal therapy.

You’ve got some quite long responses, haven’t you?

Some long responses. These are patients with metastatic castration resistant prostate cancer meaning they’ve already failed usually two lines of hormonal therapy and either one or two lines of chemotherapy, so these are in this patient population. We don’t have the data yet in the patients prior to chemotherapy.

And not so much in the way of side effects but actually fatigue amelioration?

Very few side effects, we have a poster at this year’s ESMO in which we looked at improvement in fatigue and a decrease in the fatigue interference. And it’s very clear that on those patients in the abiraterone arm, as compared to those originally in placebo, that there is a decrease in overall fatigue which is a really very important side effect of cancer and a decrease in the interference of fatigue and the interference in their daily life due to fatigue.

But lots of other things in prostate cancer, too? Ipilimumab on the horizon?

Ipilimumab is on the horizon; we have another immunotherapy that’s just been proven in the United States, it’s not approved here yet, the sipuleucel-t, it’s not approved in Europe. We have chemotherapy – cabazitaxel in the second line chemotherapy, both in the United States and in Europe, and we have a new bone targeting agent called denosumab, it’s a human monoclonal antibody against RANK ligand which affects the osteoclast which seem to release substances which increase osteoblast activity and it really decreases the rate of skeletal related events. Skeletal related events, again, are very important for men with prostate cancer because the majority of them have metastatic disease in the bone and they suffer from pain in the bone. So if you can release, you can decrease the rate of skeletal related events it’s very important.

And shortly we’ll here one of the late breaking abstracts on alpha particles and again in that very group of men with metastatic bone disease it looks as if there is a positive effect in the randomised trial.

I’m told there is a positive effect even in terms of overall survival which is surprising for something like this, this kind of a treatment. But I’m looking forward to hearing the results as well.

It’s an improvement on strontium, I can tell you that for nothing. From somebody who is old enough to be around at strontium time.

I don’t think people are using strontium that much anymore with all of these new therapies.

No, I hope not. Cora, thank you very much indeed. I’ll return you to the meeting and we’ll see you again.

My pleasure, my pleasure. It’s always a pleasure to speak to you. Thank you.