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  1. Click here to read "A Brief Update of the Current Landscape of Bone Targeted Therapies for Prostate Cancer" by Joel Nowak of Malecare. Radium 223 (Xofigo) has been approved for use in Australia. However it is not publicly subsidised. This means that its cost effectively puts it out of reach of most Australian men with advanced prostate cancer. Your committee is lobbying to try to get Radium 223 (Xofigo) publicly subsidised. However it's unlikely to be publicly subsidised in the near future.
  2. The results of a large, randomized clinical trial of the use of zoledronic acid (Zometa) were presented at the recent annual meeting of the American Society of Clinical Oncology (ASCO). In this trial the researchers set out to test whether giving zoledronic acid every 3 months would be just as effective (i.e., “non-inferior”) at reducing bone pain and skeletal-related events (SREs) in patients with bone metastases as giving it according to the standard recommended regimen (once a month) specified in the product’s prescribing information. They found that zoledronic acid administered every 3 months was just as effective to zoledronic acid administered monthly for 24 months in breast cancer, prostate cancer and multiple myeloma patients. Dr Jeffrey J. Kirshner identified this trial as one of the 10 practice-changing presentations from this year's ASCO annual meeting and said this less frequent dosing of zoledronic acid “will be less expensive and result in fewer visits for our patients and probably an improved quality of life.” References (click on the link to read) Article in the “New” Prostate Cancer Infolink Abstract of the trial presented at ASCO Comments by Dr Kirshner
  3. More from this year's Annual General Meeting of the American Society of Clinical Oncologists (ASCO). Zometa (zoledronic acid), when given to men with bone metastases, has been shown to both delay damage to bones and to extend life. The current standard of care is to give to Zometa every 4 weeks. Research presented at the ASCO Annual Meeting gave the results of a trial which compared giving Zometa every 12 weeks with giving it every 4 weeks. The trial studied 1,822 patients (with three different diseases - Prostate Cancer, breast cancer and multiple myeloma) for a period of 2 years. The trial found that administering Zometa every 12 weeks was not inferior to administering it every 4 weeks. There were no significant differences in side effects between the 2 different dosing schedules. Zometa is given to the patient via an intravenous infusion. There are obvious benefits for the patient in only having to have the treatment every 12 weeks, instead of every 4 weeks. There is also the benefit that a 12 weekly dosing schedule is cheaper than a 4 weekly dosing schedule. It is likely that this research will lead to a change in the frequency of treatments for patients on Zometa. Reference: A randomized phase III study of standard dosing vs. longer interval dosing of zoledronic acid in metastatic cancer. http://meetinglibrary.asco.org/content/147845-156
  4. Patients with castration-resistant prostate cancer and bone metastases may experience debilitating pain that impacts daily functioning and diminishes the quality of life. Previous results from a phase III trial demonstrated superiority of Denosumab (brand name Xgeva) to Zoledronic Acid (brand name Zometa) in delaying or preventing skeletal-related events (pathological fracture, radiation or surgery to the bone, spinal cord compression) in castration-resistant prostate cancer patients with bone metastases. Participants in this trial regularly completed Pain Inventory and Quality of Life questionaiires. Researchers did an ad hoc analysis of this trial which focused on the subgroup of men with no or mild pain at the start of the trial. This analysis showed that that Denosumab therapy significantly delayed the time to worsening of pain interference and maintained a higher overall cancer specific quality of life compared to Zoledronic Acid in castration-resistant prostate cancer patients with bone metastases. Should you be having Denosumab instead of Zoledronic Acid? I agree with Joel Nowak that you should "Speak with your doctor about this question.” Previous posts about Denosumab v Zoledronic Acid are at http://forums.jimjimjimjim.com/index.php?/topic/534-denosumab-or-zometa-for-protection-of-bones-in-prostate-cancer/ http://forums.jimjimjimjim.com/index.php?/topic/535-denosumab-or-zometa-for-protection-of-bones-in-breast-cancer/?hl=zometa
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