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Yesterday at ASCO: Enzalutamide on rapidly rising PSA before metastasis looking good


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Jim Marshall (not a doctor) said … 


One of the most important meetings of doctors for men with advanced prostate cancer is the ASCO (American Society of Clinical Oncology) meeting held each year. 

Yesterday at the ASCO meeting Dr Maha Hussain, on behalf of her team presented the initial results of the PROSPER clinical trial. 

That trial tested whether men with no metastases, but who had rapidly rising PSA, would do better with early Enzalutamide (Xtandi). 

This presentation is just the start of scientific reporting. Dr Hussain is presenting this study to hundreds of her colleagues so they can absorb and criticize it. Only if it stands up against criticism will doctors add it to their armament. 

Basically, if you had no visible metastases and your PSA was rapidly rising, starting Enzalutamide would delay the appearance of mets by 3 years (compared to about 1 year with no Enzalutamide). 

Your PSA on Enzalutamide would stay steady for 33 months (compared with 4 months). 

This report is just a progress report, so details of whether your life will be extended will have to wait (but the figures are looking hopeful). 

 Eligible men had no identified mets, PSA doubling time of up to10 months and a PSA of 2 ng/mL or higher.

(Thanks to member David Prestridge for spotting the pre-meeting reporting of this and alerting us to this.)


... end Jim 


The ASCO Post reported these key points yesterday: 


  • The median for the primary endpoint, metastasis-free survival, was 36.6 months for men who received enzalutamide compared to 14.7 months with ADT alone. 
  • Patients who received enzalutamide plus ADT had a 93% reduction in relative risk of PSA progression compared to patients who received ADT alone; enzalutamide plus ADT delayed the median time to PSA progression by 33.3 months vs 3.9 months with ADT alone. 
  • Enzalutamide plus ADT prolonged the median time to first use of new antineoplastic therapy by 21.9 months vs ADT alone (39.6 vs 17.7 months), a 79% relative risk reduction. [jm: antineoplastic therapy = next anti-cancer drug.]


A link to an ASCO abstract. This link may not have a long life.

PROSPER: A phase 3, randomized, double-blind, placebo (PBO)-controlled study of enzalutamide (ENZA) in men with nonmetastatic castration-resistant prostate cancer (M0 CRPC).


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