Abraxane in prostate cancer – pro
Taxanes are the most widely tested and effective chemotherapy drugs for hormone refractory prostate cancer. Weekly paclitaxel was reported to produce 25-39% PSA responses in first line and up to 33% in second line chemotherapy of patients with prostate cancer in early clinical trials. Paclitaxel activity in prostate cancer is schedule dependent, and weekly paclitaxel was reported to produce highest response rates. Docetaxel was recently approved by the Food and Drug Administration for treatment of hormone refractory metastatic prostate cancer, since it is the only chemotherapy drug with documented improvement in survival in this group of patients.
In regard to Abraxane for prostate cancer and also in regard to Abraxane an carboplatin combination:
Preclinical studies comparing Abraxane to paclitaxel demonstrated lower toxicities, with a maximum tolerated dose (MTD) approximately 50% higher for Abraxane (7) compared to paclitaxel. At equal doses there was less myelosuppression and improved efficacy than paclitaxel in a xenograft tumor model of human mammary adenocarcinoma. Clinical studies confirmed improved toxicity profile and higher response rates, in metastatic breast cancer, of Abraxane compared to cremophor EL paclitaxel (Taxol). The weekly regimen was shown to be active even in patients with cancers refractory to paclitaxel, docetaxel or when Abraxane was given after both agents. To my knowledge Abraxane for prostate cacner has only been presented at ASCO in 2001 by Berry at al.
Currently, Abraxane has only been FDA approved for metastatic breast cancer. A clinical phase II trial of abraxane as first line therapy for prostate cancer is currently recruiting (NCT00284752). It aims to evaluate the efficacy of Abraxane in first line chemotherapy of patients with hormone refractory metastatic prostate cancer, based on prostate specific antigen (PSA) response. I was not able to find any published studies of Abraxane with carboplatin.
Cabrespine A, Guy L, Khenifar E, et al. Randomized phase II study comparing paclitaxel and carboplatin versus mitoxantrone in patients with hormone-refractory prostate cancer. Urology. 2006;67:354-359
nccn.org, prostate cancer
http://clinicaltrials.gov/ct/show/NCT00284752;jsessionid=02525B00184823A7B6644A05DE4E1A7C?order=11