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Some new studies

erisian's picture
erisian
Posts: 109
Joined: Dec 2008

I got some time on a computer with access to these journal articles. You can't just go download them, unless you buy a subscription ($$$), or pay over $30.00 for one article. I got the access at my local cancer center, in their library, which is run by the ACS. It's good, but they should be ashamed of themselves- one of the articles is in one of their journals. They hold the copyright on it, yet you still have to pay unless you get free access somewhere. There's is a wall between patients and these studies and articles. I found a hole in it, but I just don't like the way that whole system works.

You can probably get your doctor's office to print copies for you, if they have subscription access. You can also read at least the abstract on the website for free, usually. The quoted sections below are from the web pages.

All you need are the "DOI" numbers. Feed them into http://dx.doi.org/, unless your browser supports DOI directly. Some do.

DOI: 10.1002/cncr.25010
Impact of recent screening on predicting the outcome of prostate cancer biopsy in men with elevated prostate-specific antigen, Sept 2009

RESULTS:
Total PSA was not predictive of prostate cancer. The previously published 4-kallikrein model increased predictive accuracy compared with total PSA and age alone (area under the curve [AUC], 0.66 vs 0.51; P < .001) but was poorly calibrated and missed many cancers. A model that was developed with recently screened men provided important improvements in discrimination (AUC, 0.67 vs 0.56; P < .001). Using this model reduced the number of biopsies by 413 per 1000 men with elevated PSA, missed 60 of 216 low-grade cancers (Gleason score 6), but missed only 1 of 43 high-grade cancers.

DOI: 10.1097/CCO.0b013e32832a1868
Emerging therapies in castrate-resistant prostate cancer, May 2009

Abstract

Purpose of review: Prostate cancer continues to represent a major health problem. It represents the most common cancer in US men, with an estimated 186 320 new cases diagnosed in 2008. It is the second leading cause of cancer death in men in the United States. Despite several attempts, the median survival for men with metastatic castrate-resistant prostate cancer is 1-2 years, with improvements in survival seen primarily with docetaxel-based therapies. Treatment options are limited, and there is a clear need for therapies that improve outcome. The purpose of this article is to discuss recent developments in the field of metastatic hormone-refractory prostate cancer, including new cytotoxic agents, antiproliferative agents, immune-based therapies, circulating tumor markers and antiangiogenic agents.
Recent findings: During this last year, several promising approaches yielded disappointing results in the phase III setting (GVAX, satraplatin, DN-101); nonetheless, expectations for other agents (abiraterone, zibotentan, Provenge) still remain high.
Summary: These new agents will need to demonstrate survival benefit for approval. Circulating tumor cells have been shown to provide important prognostic information and are anticipated to be incorporated in future clinical decision-making.

DOI: 10.1002/cncr.24429
Integrated data from 2 randomized, double-blind, placebo-controlled, phase 3 trials of active cellular immunotherapy with sipuleucel-T in advanced prostate cancer

RESULTS:
In the integrated analysis of D9901 and D9902A, patients randomized to sipuleucel-T demonstrated a 33% reduction in the risk of death (hazard ratio, 1.50; 95% confidence interval, 1.10-2.05; P = .011; log-rank). The treatment effect remained strong after performing adjustments for imbalances in baseline prognostic factors, poststudy treatment chemotherapy use, and non-prostate cancer-related deaths.

{The 36-month survival was 33% for treated, 15% for placebo.}

hopeful and opt...
Posts: 1335
Joined: Apr 2009

for sharing this knowledge.........Ira

Trew
Posts: 892
Joined: Jan 2010

While at Loma Linda U Medical Center I had the opportunity to meet a lot of other men with PC. It was very common to compare PSA and gleason scores and from what I could see there was no correlation between the two. I had a much higher gleason with lower PSA than many men. My PSA was below 10 and my gleason was a 9 at time of surgery.

From the article, it is clear more reseach is needed to development treatment for men who move into the advanced stage of cancer.

NCEllen's picture
NCEllen
Posts: 117
Joined: Nov 2009

Hi - I'm new posting on this board. I have ovarian cancer so am usually on the OVCA board- but..my husband (of a wonderful 35 years) was diagnosed with PC in 2002. He had a RP and then radiation a year later. Later started with hormone therapy, eventually had a slow-release hormone implant placed (doing that for 3 years now). Started on ketocotazole 2 years ago and with a doubling PSA taking place this year (34 to 68) since Jan., his onc. has increased the dosage of the Keto.
Anyway- he was started in a clinical trial two years ago (by Amgen), double blind study for advanced PC, hormone refractive but no mets to bone. All of his bone scans have been clear. On CT's he does show a few pelvic lymph nodes - one increasing with size while two others diminishing.
If he has been getting the trial drug (demasubab)- it is supposed to act on the bone to prevent the cancer cells from invading. In other words, it acts like a teflon coating since bones become pourous like osteoporosis with the advancement of the cancer hence the mets to bone.
So- we think he's been getting the drug, but the study ends in a couple of months. Due to the 'blind' study, we have no way to find out if he was on the clinical drug or the placebo. I called Amgen research center in Ca. and asked if the study ends, and he was getting the 'good' stuff, then what happens to him (and all the others in the study showing positive results)when he's not allowed to continue with the drug after May or June?- The clinical researcher called me back yesterday and said he forwarded my concern to a medical director, but basically when the study ends - it ends. There is no extension study planned at this time. He suggested I contact the FDA since they will have final say for controlling the drug on the market. Well, good luck right?
The FDA has to decide if it's harmful or not (even though we're dealing with cancer). I suggested there might be a 'Kervorkian' clause some where so people who are benefiting from a trial drug can continue it's use - no matter what. Any suggestions out there as to where I go from here? It's not just for my husband, but for anyone dealing with this and other cancers.
If I was on a clinical trial for my ovarian cancer, and it appeared to be working and then was just taken away from me (because I might die from it's use) well what the heck?
Sorry for such a long post - but I guess that's the pitfall of signing up for a clinical trial right? The good news is that it Might be on the market this summer - but not for PC! I can't figure it out.
Praying for all of you strong wonderful men, wives and caretakers. It's a beautiful God given day in NC even though the pollen allergies are terrible. Ellen

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