Most Read Articles
Roshini Claire Anthony, 6 days ago

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Dr. Wong Soon Tee, 28 May 2020
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Cabozantinib plus ADT an effective combo in hormone-naïve metastatic prostate cancer

02 Apr 2020

Cabozantinib plus androgen deprivation therapy (ADT) shows potent clinical activity in hormone-naïve metastatic prostate cancer (HNMPCa), according to the results of a phase II trial.

The trial included 62 patients who received ADT plus cabozantinib starting at 60 mg daily (median time from ADT initiation to cabozantinib initiation, 3.3 weeks), among which 46 had de novo metastatic disease and 54 had high-volume disease. Over a median follow-up of 31.2 months, 57 patients (92 percent) discontinued cabozantinib and 50 (81 percent) developed castrate-resistant progression. Common reasons for discontinuation included disease progression in 37 (65 percent) and toxicity in nine (16 percent).

The primary endpoint of castrate-resistant progression-free survival (PFS), assessed by radiographic criteria, clinical progression or receipt of additional therapy, was a median of 16.1 months (95 percent confidence interval, 14.6–22.7). Median overall survival was not reached.

Reductions in prostate specific antigen of ≥90 percent occurred in 50 of 60 patients (83 percent), bone-specific alkaline phosphatase of ≥50 percent were seen in 34 of 39 (87 percent), and urine N-telopeptides of ≥50 percent were recorded in 18 of 21 (86 percent).

Responses in bone scan were observed in 81 percent of 54 patients. Of the 30 patients with RECIST measurable disease (n=30), three (10 percent) achieved stable disease or best response, 18 (60 percent) achieved partial response, and nine (30 percent) achieved complete response.

Frequently reported grade 3 adverse events were hypertension (19 percent), diarrhoea (6 percent) and thromboembolic events (6 percent). Dose reductions occurred in 85 percent of the population.

On analysis of baseline cytokine and angiogenic factors (CAFs), shorter PFS was associated with higher plasma concentrations of Lumican, CXCL5, CD25 and CD30, as well as high tumour expression of pFGFR1.

The present data suggest that CAF profiles and tissue markers may be used as candidate prognostic and predictive markers of cabozantinib benefit in HNMPCa and hence guide rational therapy combinations, researchers said.

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Most Read Articles
Roshini Claire Anthony, 6 days ago

For coffee drinkers, drinking filtered coffee may be tied to a lower mortality risk, including cardiovascular disease (CVD)-related mortality, a study from Norway suggested.

Stephen Padilla, 28 May 2020
Use of noninvasive ventilation (NIV), similar to invasive mechanical ventilation (IMV), appears to lessen mortality but may increase the risk for transmission of the novel coronavirus disease (COVID-19) in healthcare workers, suggest the results of a study.
3 days ago
Use of corticosteroid is not associated with improved outcomes in idiopathic pulmonary fibrosis (IPF) patients admitted to the hospital with acute exacerbation (AE), reveals a recent study. In addition, corticosteroids may even contribute to reduced overall survival following exacerbation.
Dr. Wong Soon Tee, 28 May 2020
Acne is a common skin problem seen in primary care. Dr Wong Soon Tee of Assurance Skin Clinic at Mt Elizabeth Novena Hospital, Singapore shares his insights with Pearl Toh on how to manage acne in the primary care setting.