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In the United States men with prostate cancer can get access to Abiraterone (brand name Zytiga) and Enzalutamide (brand name Xtandi) before chemotherapy. We'd like to get to a stage in Australia where Abiraterone (brand name Zytiga) and Enzalutamide (brand name Xtandi) are available on the Pharmaceutical Benefits Scheme before chemotherapy. The Australian Pharmaceutical Benefits Advisory Committee, when considering applications to put drugs on the Pharmaceutical Benefits Scheme, looks at what its overseas equivalent bodies have done. Thanks to member Russ for letting us know that since 11 December 2015 Enzalutamide (but not Abiraterone) is now routinely available on the National Health Scheme in England and Wales, regardless of whether or not a man has previously been treated with docetaxel chemotherapy. In Scotland it's the reverse - Abiraterone (but not Enzalutamide) is now routinely available on the National Health Scheme in Scotland, regardless of whether or not a man has previously been treated with docetaxel chemotherapy. http://prostatecanceruk.org/about-us/news-and-views/2015/12/nice-decision-on-abiraterone-and-enzalutamide-without-chemotherapy
Paul Edwards posted a topic in New agentsThe Malecare Advanced Prostate Cancer Blog reported on research data presented at the 7th European Multidisciplinary Meeting on Urological Cancers held in Barcelona from 12-15 November 2015. Patients who were treated with abiraterone acetate (Zytiga) or denosumab at the same time as they were treated with Ra-223 had better Overall Survival. Patients who had a good ECOG performance status*, no pain and low alkaline phosphatase (ALP)# had significantly longer Overall Survival. * ECOG performance status Clinical trials require the use of standard criteria for measuring how the disease impacts a patient’s daily living abilities (known to physicians and researchers as a patient’s performance status). The ECOG Scale of Performance Status is one such measurement. It describes a patient’s level of functioning in terms of their ability to care for themself, daily activity, and physical ability (walking, working, etc.). The scale was developed by the Eastern Cooperative Oncology Group (ECOG). # Alkaline phosphatase (ALP) This is a protein that the body produces mainly in the liver and in bones. With prostate cancer, elevated levels of ALP are associated with the formation of metastases in the bones.
Paul Edwards posted a topic in New agentsThanks to Chuck Maack for drawing our attention to the report of a recent presentation by Dr Oliver A Sartor who was the principal North American investigator for the clinical trial that led to the approval by the United States Food and Drug Administration (FDA) for radium 223 (brand name Xofigo). In 2013 the FDA approved radium 223 for treatment for patients with castration-resistant prostate cancer, symptomatic bone metastases, and no known visceral metastatic disease. Dr Sartor said that determining whether or not a patient had symptoms of bone metastases could often be a grey area. He considered the extent of bone metastases was more important than the presence of pain in determining whether to treat a patient with radium 223. Dr Sartor was treating patients with metastatic castration-resistant prostate cancer who had a significant burden of bone-metastatic disease, even though they might not be considered symptomatic. After nearly a year of clinical use, Dr Sartor said that the optimal setting for radium 223 appeared to be in combination with new hormonal therapies such as Abiraterone (Xytiga) and Enzalutamide (Xtandi). At present a large multi-country Stage III clinical trial is about to start recruiting in Australia: Radium-223 Dichloride and Abiraterone Acetate Compared to Placebo and Abiraterone Acetate for Men With Cancer of the Prostate When Medical or Surgical Castration Does Not Work and When the Cancer Has Spread to the Bone, Has Not Been Treated With Chemotherapy and is Causing no or Only Mild Symptoms Dr Sartor said large clinical trials would be needed before radium 223 could be considered for use on patients who did not have metastatic disease or were not castration-resistant.