Docetaxel, bevacizumab, and androgen deprivation therapy for biochemical disease recurrence after definitive local therapy for prostate cancer. By McKay et al. 2015
Key sentence from the paper: “Since the initiation of the current study, new treatment option for the management of metastatic CRPC have emerged… The approval of these agents provides a rich opportunity to explore sequential and combinatorial approaches and early administration for patients with hormone-sensitive prostate cancer.”
For the full abstract, see: http://www.ncbi.nlm.nih.gov/pubmed/25903013
Commentary: This is a small study, with 41 patients who were experiencing "biochemical disease recurrence" after having definitive surgery and radiation for prostate cancer. The patients received not only ADT, but also chemotherapy with docetaxel and bevacizumab
Bevacizumab is a humanized monoclonal antibody to vascular endothelial growth factor (VEGF). The study began back in June 2008. At that time there was some hope that antibodies, which attacked VEGF, might help control cancer by cutting off its blood supply. Several anti-VEGF agents have been tested, but none have been shown to be particularly helpful in treating prostate cancer.
The results of this study were mixed. At a median follow-up of 27.5 months about a fifth of the patients had PSA control, however a large number of patients experienced grade 3 or 4 toxicities and discontinued treatment because of those toxicities.
Although the oncological results were not as great as one might have hoped, this study is a model for what we are likely to see in the future, where multimodal systemic therapies will be used in various combinations. In the past chemotherapy for prostate cancer has shown little survival benefit and has therefore been left as a treatment of last resort. Now, with so many new agents out there to treat prostate cancer, we can expect more studies like this one - both trying new drugs earlier, and in combination with other therapeutic agents.
McKay RR, Gray KP, Hayes JH, Bubley GJ, Rosenberg JE, Hussain A, Kantoff PW, Taplin ME. 2015. Docetaxel, bevacizumab, and androgen deprivation therapy for biochemical disease recurrence after definitive local therapy for prostate cancer. Cancer. 22 April 2015 [Epub ahead of print]