SIDEBAR: Timing of Prostate Cancer Drugs: Earlier But Not Too Early?

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While sipuleucel-T, abiraterone, and cabazitaxel have been approved for patients with advanced disease, they might also be used in patients with earlier-stage disease, according to Christopher J. Logothetis, MD, of MD Anderson Cancer Center. “I think it is fair to say that they will be used better and more efficiently in a select group of patients early in the disease. There are already trials using abiraterone in the preoperative setting before radical prostatectomy and they show promise in what appears to be an enhanced effect on the tumor,” he reported.

“The unique problem with prostate cancer is that ‘earlier therapy’ can sometimes be too early,” Dr. Logothetis said. “If patients are only exposed to the drugs for 5 years, the side effects may be modest, but if patients live for an entire decade or more, continued exposure to therapy may be significantly more toxic. The goal is to offer therapies after the cancer has demonstrated its potential to get aggressive, but before the cancer is visibly causing problems. To do this, we need to develop better biomarkers that identify the transition to an aggressive cancer before it becomes obvious clinically,” he said ■

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