Practice changing data and new developments in the management of prostate cancer – ASCO 2010
In the 2010 ASCO meeting valuable information and even practice-changing results for the medical treatment of castration resistant prostate cancer (CRPC) were presented. Focus was put on bone-targeted treatment, chemotherapy for second line use, combinations of standard chemotherapy with different new drugs and data on a novel antiangiogenic compounds. Denosumab was shown to be superior to zoledronic acid in the treatment of patients with bone metastases of CRPC. Cabazitaxel improved survival in CRPC patients who progressed during or after docetaxel. This substance might become the first standard treatment for second line use. There are still concerns about the dose and toxicity. Both new drugs still need to be approved but will change our practice in the management of bone metastases and in the second line setting and enlarge significantly our small armamentarium of medical treatment of CRPC. So far, there is no proven benefit in adding any drug to standard docetaxel. This fact was confirmed by final data analyses of the combination of docetaxel with bevacizumab or calcitriol. Tasquinimod is a promising novel anti-angiogenic compound that delayed disease progression significantly in asymptomatic CRPC patients. A phase III-trial will reveal the true value of this compound. In conclusion, in the 2010 ASCO meeting, valuable new information concerning the medical treatment of CRPC was conveyed which might indeed change our clinical practice.