Angiogenesis Inhibition in Prostate Cancer: Current Uses and Future Promises

Angiogenesis has been well recognized as a fundamental part of a multistep process in the evolution of cancer progression, invasion, and metastasis. Strategies for inhibiting angiogenesis have been one of the most robust fields of cancer investigation, focusing on the vascular endothelial growth factor (VEGF) family and its receptors. There are numerous regulatory drug approvals to date for the use of these agents in treating a variety of solid tumors. While therapeutic efficacy has been established, challenges remain with regards to overcoming resistance and assessing response to antiangiogenic therapies. Prostate cancer is the most common noncutaneous malignancy among American men and angiogenesis plays a role in disease progression. The use of antiangiogenesis agents in prostate cancer has been promising and is hereby explored

Biclonal gammopathy in a patient taking efalizumab for the treatment of psoriasis

We report a patient who developed biclonal gammopathy of undetermined significance during treatment withefalizumab for psoriasis. This plasma cell disorder was found during the evaluation of the patient’s complaint of mild lower extremity paresthesia. The gammopathy spontaneously remitted following cessation of therapy and has not recurred to date. Given the increasing use and development of biological agents for the treatment of psoriasis and other disorders, this finding and the mechanisms by which it may have occurred is of clinical significance

Ramucirumab plus docetaxel versus placebo plus docetaxel in patients with locally advanced or metastatic urothelial carcinoma after platinum-based therapy (RANGE): a randomised, double-blind, phase 3 trial

Few treatments with a distinct mechanism of action are available for patients with platinum-refractory advanced or metastatic urothelial carcinoma. We assessed the efficacy and safety of treatment with docetaxel plus either ramucirumab-a human IgG1 VEGFR-2 antagonist-or placebo in this patient population

The promising role of poly(ADP-ribose) polymerase inhibitors in prostate cancer

The TOPARP study showed the beneficial utility of olaparib in a heavily pretreated population of metastatic castration-resistant prostate cancer who were biomarker-positive for aberrations in DNA repair gene. A higher response rate to olaparib of 88% (14 out of 16 patients), time to radiographic progression as well as overall survival, was seen in patients who were biomarker-positive compared to those who were not. This study showed a promising way of targeting prostate cancer with an enriched population of patients who harbor these deleterious genes. This paves the way for offering new therapeutic opportunities for men who have otherwise few remaining options

Further analysis of PREVAIL: Enzalutamide use in chemotherapy-naïve men with metastatic castration-resistant prostate cancer

PREVAIL was a phase III multinational, double-blind, placebo-controlled trial that enrolled chemotherapy-naïve men with metastatic castration-resistant prostate cancer (mCRPC), which showed remarkable improvement in co-primary endpoints with an overall 81% reduction in the risk of radiographic progression, as well as 29% reduction in the risk of death in favor of the enzalutamide arm over placebo. All secondary endpoints including time to subsequent chemotherapy initiation and prostate specific antigen (PSA) progression were in favor of the enzalutamide arm. The results of PREVAIL shows the utility of enzalutamide that would likely soon expand the indication to asymptomatic or minimally symptomatic men with mCRPC not previously treated with chemotherapy

Use of early chemotherapy for hormone-sensitive prostate cancer: time for CHAARTED

CHAARTED was an ECOG-led phase III trial looking at early chemotherapy with the use of docetaxel in addition to androgen deprivation therapy (ADT) versus ADT alone in hormone-sensitive prostate cancer. The positive results of the trial showing marked improvement in overall survival in those who received chemotherapy with ADT have revolutionized the treatment of metastatic castration-sensitive prostate cancer. In addition to overall survival, secondary endpoints such as time to castration resistance, PSA response were also significant for the patients who received early chemotherapy