March 8, 2009

Neoadjuvant Taxotere® and Iressa® Well Tolerated in Men with Locally Advanced Prostate Cancer


Neoadjuvant Taxotere® and Iressa® Well Tolerated in Men with Locally Advanced Prostate Cancer

According to the results of a Phase II clinical trial, neoadjuvant (before surgery) treatment with Taxotere® (docetaxel) and Iressa® (gefitinib) is well tolerated in men with high-risk locally advanced prostate cancer. This study was published in the journal Cancer.

Locally advanced prostate cancer refers to cancer that has spread from the prostate to nearby sites, but not to distant sites in the body. Standard treatment for locally advanced prostate cancer may include surgery, radiation therapy, and/or hormone therapy.

Men with certain risk factors, such as a high Gleason score, spread of cancer outside the prostate, or lymph node involvement, have a high recurrence rate even if all detectable cancer is surgically removed, radiated, or both. There are several clinical trials that suggest that the results of surgery and radiation therapy can be improved with androgen suppression before, during, and/or after therapy.

An alternative approach is to use neoadjuvant and/or adjuvant chemotherapy. Neoadjuvant chemotherapy refers to chemotherapy that is given before other treatments (such as surgery or radiation), and adjuvant chemotherapy refers to chemotherapy that is given after other treatments. Taxotere is a chemotherapy agent that has been shown to be active against prostate cancer. Iressa is a targeted therapy that could potentially increase the effectiveness of Taxotere.

To evaluate the combination of Taxotere and Iressa in the neoadjuvant setting, researchers conducted a Phase II clinical trial among 31 patients with locally advanced prostate cancer. All patients received Taxotere and Iressa for two months before radical prostatectomy.

  • Most patients (94%) experienced a partial reduction in detectable cancer following treatment with Taxotere and Iressa, but no patients experienced a complete disappearance of cancer. Improvement on MRI was noted in 35% of patients.
  • The combination of Taxotere and Iressa was well tolerated and did not increase surgical complications.

This study shows that adding Iressa to Taxotere was well tolerated. It will take a randomized trial to determine if adding Iressa improves outcomes.

Reference: Vuky J, Porter C, Isacson C, et al. Phase II trial of neoadjuvant docetaxel and gefitinib followed by radical prostatectomy in patients with high-risk, locally advanced prostate cancer. Cancer [early on-line publication]. January 9, 2009.

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