USA Leads the Way in Prostate Cancer Therapy With Zytiga

The USA leads the way in using cutting edge drugs in clinical practise and Zytiga is now beeing used in 48% of prostate cancer patients in the USA who have progressed following chemotherapy. The use of Zytiga before chemotherapy is less frequent since it has not yet been FDA approved in this scenario. Zytiga has a lot of advantages over other options such as chemotherapy and its approval before chemotherapy by the FDA is being fast tracked with an announcement expected in December.

The abiraterone.blogspot website was set up to give as much information as possible to prostate cancer sufferers about abiraterone acetate (Zytiga) which is a promising new treatment for prostate cancer. This blog also strives to give up to the minute information on other new treatment options for prostate cancer and information on new drugs as they emerge. Regular updates on feeback from patients taking Zytiga are included together with news on new Zytiga combinations with promising potential. This information has been most widely viewed in the USA and the UK with viewers also coming from India and the Ukraine.

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Jevtana Vs Zytiga

Both Jevtana and Zytiga are licensed for use following Docetaxel chemotherapy so what does each have to offer ?

Jevtana is another form of chemotherapy and is a taxane similar to Docetaxel. Jevtana has all the side effects of chemotherapy including liver and kidney damage as well as toxicity to white blood cells causing immunosuppression. Clinical trials showed that Jevtana treatment extended life by only 2.4 months.

Jevatana (Cabazitaxel) is given as an injected infusion every three weeks in a cycle of 3 rounds of chemotherapy. Its cost is around £ 8,000 per infusion and it is not yet approved by NICE for use on the UK NHS.

Zytiga is a form of hormonal therapy that does not suffer from the side effects of chemotherapy and this is why it is the preffered treatment over Jevtana. Zytiga is taken as an oral tablet once daily and is able to work against advanced metastatic disease for which it is FDA apporved. Zytiga is also approved for use on the NHS in the UK.

Stelara Shines in Trials

Stelara the new treatment for Psoriasis has succesfully completed clinical trials and has now been licensed and FDA approved for the treatment of acute psoriasis. Stelara is a monoclonal antibody therapy which is given as a monthly 45 mg subcutaneous injection. The ACCEPT clinical trials showed that Stelara (aka Ustekinumab) effectively treated psoriasis with minimal side effects. Stelara has been designed as a very selective form of therapy specifically targetting IL-12 which is involved in psoriasis plaque formation. By selectively targetting IL-12 Stelara is able to exert its effects aginst psoriasis withou causing any other side effects.

Stelara, Zytiga, and Xarelto are 3 new bockbuster drugs from health giant Johnson & Johnson who know a good drug when they see one, and have selected key drugs in there respective clinical settings. Stelara has unique activity against psoriasis, Zytiga is highly effective against advanced prostate cancer, and Xarelto is an effective anticoagulant used to prevent strokes.

Xarelto Receives FDA Approval

Xarelto the new potential blockbuster by Zytiga manufaturers Johnson & Johnson has received FDA approval for treating variuos types of heart disease and cardiovascular disorders. These include treatment and prohylaxis of AtrialFibrillation, Stroke, and Deep Vein Thrombosis (DVT). Xarelto is the trade name of the powerful anticoagulant agent Rivaroxaban which is an inhibitor of blood clotting factor X alpha. It has powerful anticoagulant effects and prevents blood clots from forming. It is effective at a very low dose of only 10 mg daily taken orally so it is a very convenient and effective means for preventing conditions where blood clots cause problems such as stroke and deep vein thrombosis.

Johnson & Johnson really are on to two winners here producing both Zytiga and Xarelto. It may be that some people need to take both Zytiga and Xarelto together for example patients with advanced metastatic prostate cancer that are also suffering form atrial fibrillation or are at risk of stroke. So these medications may well be used in the same patient populations and these 2 drugs should work well together. The best timing would be to take the Zytiga dose first thing in the morning with 5 mg prednsione, and then 4 hours later to take 10 mg of the Xarelto and the other 5 mg of prednisone. This way there will be minimal pharmacological reactions between the 2 drugs. Both drugs are cleared from the body by the enzyme CYP3A4 and so will compete for this enzyme which will extend the half lives of both these compounds. By offsetting the dosing schedule the competition for CYP3A4 will be reduced and both drugs metabolised safely.

Zytiga Required Before Xtandi Insurance Cover

Insurance companies in the US are only covering Xtandi for use after Zytiga therapy has failed. This clause for the use of Xtandi requires prior use of Zytiga and have clinically progressed on this treatment. Only then will the insurance companies cover the use of Xtandi. This is probably because Xtandi costs $7,500 per month which is considerably more than Zytiga at $5,000 per month.

However there is no clinicall evidence so far that Xtandi works in Zytiga relapsed patients. Patients who have Zytiga Resistant Prostate Cancer (ZRPC) have tumours that have become completely hormone independent so they are unlikely to respond to another antihormonal therapy such as Xtandi. Zytiga has been shown to work when Xtandi has failed but there is currently no evidence that Xtandi will work when Zytiga has failed.

The trial of the closely related antiandrogen AR-509 shows hope that Xtandi may show reponses after Zytiga, since AR-509 is a closely related analogue of Xtandi, and the clinical trials on AR-509 showed a 10% response rate in prostate cancer patients who had previously received Zytiga. So there is hope that at least some patients may benefit from Xtandi post Zytiga.

Cigarette Smoking Protects Against Side Effects of Chemotherapy

Surprising new research results are showing that cigarette smokers suffer less from the side effects of chemotherapy than non-smokers. This is the first time that cigarette smoking has been shown to have positive health benefits. In particular cigarette smokers suffered less damage to the important white blood cellls. This was reflected in a decreased incidence of neutropenia among cigarette smokers. Importantly the white blood cell count (WBC) remained good in the smokers.

The reason for this effect may be due to modulation of the nicotinoid receptors ro could be due to the fact that cigarette smokers are accustomed to having toxic compounds in the body which renders them less susceptible of the toxic effects of the chemotherapy.

Maybe the effects of smoking marijuana should also be investigated on alleviating other side effects of chemotherapy in addition to its use in relieving pain as a narcotic and medical marijuana oil extracted from cannabis indica and cannabis sativa has shown remarkable anticancer properties in its own right due to the THC and CBD acting at the cannabinoid receptors. Smoking cannabis with tobacco will modulate both the cannabinoid and nicotinamide receptors and should work together to alleviate the side effects of chemotherapy.

The research results are summarised below:

Smoking Protects Against Side Effects of Chemotherapy

Purpose:
Compounds in cigarette smoke are known to interact with the metabolism of several anticancer drugs. They may also affect the incidence and severity of adverse events and the efficacy of chemotherapy. The main objective of this study was to examine the effects of smoking tobacco on the pharmacokinetics and toxicities of patients treated with the chemotherapy agents docetaxel (Taxotere) or paclitaxel (Taxol).

Experimental Design:
Smoking status, toxicity profiles, and pharmacokinetic parameters were determined in 566 patients (429 nonsmokers and 137 smokers) treated with docetaxel or paclitaxel.

Results:
Smokers treated with docetaxel showed significantly less grade IV neutropenia (35% vs. 52%) than nonsmokers. Smokers treated with paclitaxel had less grade III–IV leukopenia than nonsmokers (12% vs. 25%), and the white blood cell count (WBC) nadir was lower in nonsmokers (median, 2.7 x 10⁹/L; range, 0.05 x 10⁹ to 11.6 x 10⁹/L) than in smokers (median, 3.3 x 10⁹/L; range 0.8 x 10⁹ to 10.2 x 10⁹/L). Of interest, significantly lower WBC counts and absolute neutrophil counts at baseline were seen in nonsmoking patients treated with paclitaxel (P = 0.0001). Pharmacokinetic parameters were similar in smokers and nonsmokers for both taxanes.

Conclusion:
Cigarette smoking does not hinder the action of docetaxel and paclitaxel. Cigarette smokers treated with the chemotherapy agents docetaxel and paclitaxel had significantly less side effects of neutropenia and leukopenia, and further research is warranted to elucidate this potential protective effect.

Zytiga Inventor Receives Award from Canada

The inventor of Zytiga Professor Gerry Potter has received an award from Canadian cancer diagnostics company CARE Biotechnologies. Zytiga is now approved by Health Canada and is now available in Canadian pharmacies. It is licensed for post chemotherapy use after the drug docetaxel has failed. Professor Potter said on receiving the award "It is so frustarting that Zytiga is not licensed before chemotherapy afterall it is a far safer drug and should be used before chemotherapy is even thought of. Chemotherapy should be alast ditch event after Zytiga has failed not the other way round. Its about time that the FDA approved Zytiga before chemotherapy so that many more men can benefit from this treatment. I designed this drug to replace chemotherapy which is an outdated form of cancer treatment that causes serious side effects. Docetaxel is toxic to the liver, kidneys, and white blood cells so causes severe immunosuppresion. This is not good depleting the cancer patients immune system destrying the very cells that help in cancer recovery. So it really is a nonsense using those sorts of chemotherapy and its about time we abandoned that approach completely. Zytiga makes chemotherapy obsolete and so of course it should really be used as a first line therapy. I'm very please this drug is now benefiting prostate cancer patients in Canada"

Professsor Dan Burke made the award on behalf of CARE biotech, a company specialising in proteomic approaches to early cancer detection that resulted as a spin out from Professor Potter's research on the CYP1B1 and CYP17 enzymes.

www.IJOPT.org