Admin Posted June 10, 2019 Share Posted June 10, 2019 Looking after those bones: Zometa or Denosumab for metastatic castrate resistant prostate cancer In short Recommendations are that men with metastatic castrate resistant prostate cancer look after their bones with one of two bone protecting agents. At the ASCO (American Society of Clinical Oncology) 2019 meeting, Dr Bertrand Tombal reported that despite this, only about one third of eligible men are getting these bone agents. If you have metastatic castrate resistant prostate cancer, and are not on one of these bone agents, there may be good medical reasons for this, but this may be something to discuss with your doctor. More detail Two bone protecting agents: Zometa (zoledronic acid or zoledronate); and Xgeva (denosumab, a monoclonal antibody) have been available for some time. In Australia both treatments are available for a nominal cost on the PBS for men with metastases due to castrate resistant prostate cancer. Studies The ERA-223 clinical trial of Zytiga (abiraterone) with Xofigo (Radium-223) was stopped when it was found that the combination caused a significant increase in the risk of fractures and death. The EORTC-1333-GUCG/PEACEIII clinical trial was in an early stage. It compared enzalutamide with a combination of Radium-223 plus enzalutamide for men with few, or no symptoms of metastatic castration-resistant prostate cancer. Seeing the ERA-223 results, the researchers changed their study rules so new subjects should take bone protection agents. In the men who had not had the bone protection agents, after one year there was for men with enzalutamide: a 12.4% cumulative risk of fracture; for men with enzalutamide and Radium-223: a 37.4% cumulative risk of fracture. In the men who did have the bone protection agents, starting 6 weeks before treatment, after one year there was for men with enzalutamide: no fractures; for men with enzalutamide and Radium-223: no fractures. I'm not a doctor, but there seems to be a clear message here! Jim Link to comment Share on other sites More sharing options...
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