ASCO 2014: old dogs, new tricks top the bill

pharmafile | June 2, 2014 | News story | Research and Development, Sales and Marketing ASCO, Cancer, chicago, docetaxel, exemestane 


Research showing the effectiveness of established cancer treatments in new settings is taking centre stage at this year’s American Society of Clinical Oncology (ASCO) meeting in Chicago.

Among the studies featured at the event’s plenary – or highlights – session were late-stage trials of exemestane, first approved nearly a decade ago and sold by Pfizer as Aromasin; and docetaxel, for which Sanofi first got the FDA nod in the mid-90s as Taxotere. Both drugs have been available in generic form for several years.

As it stands exemestane is commonly administered to reduce breast cancer recurrence after surgery in older, post-menopausal women whose naturally low oestrogen levels facilitate the drug’s effectiveness.

In a new trial researchers were able to deliver the same benefit to young patients by coupling the drug with an ovarian function suppressant, which artificially lowered the amounts of oestrogen in their bodies.

As part of this regimen, the drug was found to be significantly better at preventing the return of breast cancer five years after surgery than hormone therapy tamoxifen, the current standard of care.

The study’s lead author Olivia Pagani heralds the results as confirmation of a new treatment option for pre-menopausal breast cancer patients. But she cautions that future follow-up of participants would be crucial to determine long-term side effects and survival rates.

In an analysis of the trial, former ASCO president Nancy Davidson also draws attention to the considerably higher cost of exemestane versus tamoxifen: around $7300 compared to $1300, respectively, per year of treatment.

In the second highlighted study, chemotherapy drug docetaxol was investigated as an addition to standard hormone therapy in men with newly-diagnosed prostate cancer which had spread to other parts of their bodies.

Compared to hormone therapy alone, the docetaxol combination increased overall survival – the gold standard in cancer research – by around 13 months.

Evaluating the research, Michael Morris, an oncologist at the Memorial Sloan-Kettering Cancer Center in New York, says: “If you look at the drugs available that prolong overall survival for castration-resistant prostate cancer, none even come close.”

He adds: “This study has changed the standard of care in the face of diminishing resources.”

However, lead researcher Christopher Sweeney warns that the addition of chemotherapy to standard treatment was recommended only for patients deemed ‘chemo-fit’ – i.e., those strong enough to handle its adverse effects.

Hugh McCafferty

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