2012 ~ A Year of Hope for the PCa Guy...

These are my own observations on why 2012 was a good year for Prostate Cancer...

I know it's hard to tell you guys diagnosed in 2012 that it was a great year for PCa but it was. I've been at this now for 6 years and in my observations it was a great year for treatment options, decision making, and for general understanding about the disease. There was even some hints at a screening test that could decipher the well needed answer to the question as to sorting out indolent versus aggressive disease though I remain a bit skeptical on that one. Here is how I observed 2012...

1> With the US Preventive Services Task Force Grade D recommendation to end screening for prostate cancer that came out in May we saw a brisk and sudden change in the medical community to start more with a proceed with caution approach versus rushing to treat early stage prostate cancer. Perhaps with that approach prior to May there is no such recommendation. I do believe that the recommendation by the USPSTF is a bit reckless as I view it as throwing the baby out with the bath water, but the attention was very high and there is more restraint to treatment before further analysis.

2> Xtandi hit's the streets. Enzalutimide, also known as MDV3100, is a super strong "bicalutimde", if you will, an AR drug, and it has shown some excellent results in treating men with both hormonally responsive and castrate resistent prostate cancer.

3> Zytiga, or Abiraterone Acetate, was released last year for use after chemotherapy, but the key question of whether it will work even better BEFORE chemotherapy is showing great promise. Many are on the drug early and the results have been encouraging.

4> TAK700 and ARN509. These two will continue to gain attention in 2013 as both are expected to receive FDA approval for treating castrate resistant prostate cancer. And once again, the question as to whether these drugs should be used before the disease becomes castrate resistant will be key questions for 2013.

5> Radium 223. This is systemic radiation therapy and it has been submitted for approval in the US by Bayer after showing survival benefit for metastatic, hormonally resistant prostate cancer in phase III trials in Europe.

We also have seen some improvements in imaging techniques in hopes of finding metastatic lesions sooner, but I feel we are still short of the mark with imaging. Still improvements provide hope of avoiding bone pain and spread of metastatic disease that can indeed be beneficial for many cases. But I remain on the fence as we need to be able to improve detection of progression in metastatic cases. Cellsearch, and the Circulating Tumor Cell (CTC), have given us a new tool in previous years to detect circulation of prostate cancer in our systems, and 2013 sees us using it to test the effectiveness of therapies while on advanced therapies, but we can get better here, too. There is little use of a CTC scan and the new imaging techniques in cases where after front line therapies have failed and PSA is rising but no other evidence of metastatic lesions exists.

I continue to see more good things coming but I am also fortunate to have a little insight that others might not have after becoming a GU committee member in 2012 at SWOG for prostate cancer investigational drug trials. It has been quite humbling but very enlightening.

Stay tuned for 2013! And Stay Positive! And have a Happy New Year!

Tony Crispino
SWOG Patient Advocate - Prostate Cancer
Chapter President - UsTOO Las Vegas
Prostate Cancer Education and Support
(702) 917-7779

Thank you Robert.
Some of the ones you listed that I did not are still a ways off and may or may not make it to market for 2013. But they are on my radar for the future.

Tony

Indeed it does, Robert. A good example is that I just worked on a trial protocol that will be activated for accrual in early 2013 that has prostate cancer specific mortality as its end points. This trial asks the question if TAK700 is better than Bicalutimide as an AR in early hormonal therapy cases. The estimated time for an answer is up to ten years. The answer will likely be available sooner but that's a long haul by any measurement. But the good news is that TAK700 will be approved soon and it does not require a steroid in the trial which is good news for everyone...

Tony

Post Edited (TC-LasVegas) : 12/31/2012 10:30:44 PM (GMT-7)

Thanks for the summery Tony. The future certainly looks a lot brighter than the past for PC sufferers at least.

Happy New Year. And may 2013 be as wonderful as circumstances allow, for all my brothers here.

Mag

 

A good summary, some of these changes and improvements seem to get shuffled and lost among all the other news, nice to see it as a consise listing like this.

Yes, there is always reason for hope. Technology is changing rapidling, including medical advances, and this of cours, includes new and future treatments for prostate cancer. No reason for anyone to give up hope.

We need to focus on reducing the still around 30,000 men that die of this terrible cancer each year, that is 30,000 too many.

I think the reccomendation of eliminating/reducing screening was the worse move of 2012, and so counter-productive. Over-screening isn''t a problem, over treating indolent cancers - well, that can be argued, and there's ways of working on that problem. But burying one's head in the sand on the screening end isn't the way to go. I still say its better to know, then not to know, and the sooner one knows what they are dealing about, the better the treatment options are available.

david