Castrate resistant prostate cancer: New therapeutic approaches

Today Dr. Martin Gleave of the Vancouver Prostate Centre in Canada gave a lecture about new approaches to treat castrate-resistant prostate cancer (CRCP) during the 24th Annual Congress of the European Association of Urology in Stockholm, Sweden. "If we look at the way kidney cancer treatment has changed over recent years we see a glimpse of the future", says Dr Gleave, "Targeted therapies may become available".

Recent studies indicate that tumour cells can develop an ability to synthesise enzymes to produce their own androgens for androgen receptor (AR) activation after castration.

CRPC tumours are not uniformly hormone resistant and may remain sensitive to therapies directed against the ARs. Dr Gleave: "Several new classes of AR-targeting agents are now in clinical development, including the 2nd generation anti-androgen MDV3100, abiraterone, and Hsp27 (OGX-427)".

The growth of new blood vessels, angiogenesis, plays an essential role in prostate cancer development and metastasis. "Among the various angiogenic targets implicated in tumour angiogenesis, vascular endothelial growth factor (VEGF), a potent angiogenic growth factor, and its receptor have evoked a lot of interest," according to Dr Gleave. Bevacizumab targets VEGF and is a promising angiogenesis inhibitor in this indication. Other agents in late stage trials include sunitinib.

Clusterin is a stress-induced, multi-functional, molecular chaperone. A novel, phase I pre-prostatectomy trial defined the optimal biologically dose and toxicity parameters of OGX-011 with maximal knockdown of clusterin in prostate and lymph node tissues at the 640 mg dose level. A phase II study includes 81 men with CRPC to receive either docetaxel and OGX-11 (n=40) or docetaxel alone (n=41).

"All in all, we need to move forward with the momentum and continue to let biology guide treatment developments", said Gleave, who also expressed his gratitude for being invited to speak at the 24th Annual EAU Congress.

Source: European Association of Urology