Blinded by the light: Irofulven chemotherapy trials

By JACQUELINE STRAX December 16, 2005 /PSA Rising/ The chemotherapy drug Irofulven, a drug based on a poison in the jack o’lantern fungi, is in clinical trials in the USA, Canada and Europe for prostate, ovarian, hepatic and other cancers. A surprising side effect is retinal damage.

Higher Vitamin D Daily Dose Could Halve Colon Cancer Risk, UCSD researchers say

December 20, 2005 – Taking 1,000 international units (IU) of vitamin D 3 daily appears to lower an individual’s risk of developing colorectal cancer by 50 percent, according to cancer prevention specialists at the Moores Cancer Center at the University of California, San Diego (UCSD) Medical Center. Full story

Latest Business News and Financial Information | Reuters.co.uk
Body backs Sanofi’s Taxotere in prostate cancer

LONDON (Reuters) – A cost-effectiveness watchdog said on Friday it was provisionally recommending that Sanofi-Aventis SA’s chemotherapy drug Taxotere should be used to treat prostate cancer on the state health service.

A spokesman for the National Institute for Clinical Excellence said final guidance was likely to be issued around July next year, covering the use of the drug in men with advanced hormone refractory prostate cancer.

Until then, about 800 men in Scotland who could benefit from Taxoterer to releive pain and progression of advanced prostate cancer are on hold. Some of them may die waiting.

“Men with prostate cancer who are initiating ADT have a 5- to 10-fold increased loss of bone density at multiple skeletal sites.” They also lose lean body mass and gain fatty tissue.

Men taking anti-androgen drug therapy to suppress their male hormones are at risk for loss of bone mineral density (BMD) . This puts the men at risk of fractures including of rib, spinal, and/or hip. Until recently, no information was available to patients from the drug manufacturers nor from doctors about how soon after starting after starting on androgen blockade this condition is likely to start.

Forbes has a story this month about a Cox-II inhibitor, Celebrex. While mostly used for arthritis pain, this drug is of high interest to cancer patients as a possible tumor inhibitor (for background on the cancer connection see
Cancer Patients … and Celebrex in Anti-Cancer Trials Nov 2004

Dr. Zvi Fuks, a renowned radiation oncologist, is one of the principal developers of 3-D conformal radiation therapy, a system for delivering radiation that permits precise shaping and targeting of radiotherapy beams. He has worked for many years at MSKCC (memorial Sloan-Kettering Cancer Center).

Last month Dr. Fuks and a friend agreed to pay a total of $2.77 million to settle a lawsuit accusing them of insider trading in shares of a pharmaceutical company. The drug involved, ImClone’s Erbitux, was tested in clinical trials at MSKCC. A clinical trial of Erbitux for prostate cancer ran at MSKCC starting in 1996.

By GARDINER HARRIS
Published: December 21, 2005
WASHINGTON, Dec. 20 – Despite promising discoveries and multibillion-dollar investments, cancer research is quietly undergoing a crisis. Federal drug regulators will soon announce several initiatives that they hope will help salvage the field.

Few drugs are being marketed, and most of those that have been introduced are enormously expensive and provide few of the benefits that patients expect. Officials of the Food and Drug Administration suggest that the failures may result from an obsolete testing system.

There is growing evidence that X-rays, long the standard, may not accurately assess a patient’s disease. The drug agency is creating collaborations to develop imaging, blood and other tests that better signal the progression of cancer.

“We need to develop cancer drugs differently,” the chief operating officer of the agency, Dr. Janet Woodcock, said in an interview. “The tools we have to develop these treatments are not what we need in cancer.”

Entrez PubMed
Cancer Biol Ther. 2006 Jan 25;5(1) [Epub ahead of print]
Corticosteroid-Induced Chemotherapy Resistance in Urological Cancers.

Zhang C, et al. Molecular Urooncology, German Cancer Research Center, Heidelberg, Germany.

Purpose: Glucocorticoids such as dexamethasone are widely used for medication of urological diseases, e.g., as cotreatment of advanced prostate cancer, to improve appetite, weight loss, fatigue, relieve bone pain, diminish ureteric obstruction, to reduce the production of adrenal androgens, as an antiemetic in patients undergoing chemo- and/or radiotherapy together with serving as “standard” therapy arm in randomized studies.

While the potent pro-apoptotic properties and the supportive effects of glucocorticoids to tumor therapy in lymphoid cells are well studied, the impact to growth of prostate and other urological carcinomas is unknown.

Methods: We isolated cells from surgical resections of 21 prostate tumors and measured apoptosis and viability in these primary cells and 17 established cell lines from human prostate, bladder, renal cell and testicular carcinomas.

Results: We found that dexamethasone induces resistance regarding exposure to several cytotoxic agents such as taxol, gemcitabine, cisplatin, 5-FU and gamma-irradiation in 86% of the freshly isolated prostate tumors and in 100% of the established urological cell lines.

No difference in dexamethasone-mediated protection was found in normal, benign and malignant prostate tumors.

Conclusions: These data show for the first time that dexamethasone induced therapy resistance in urological carcinomas is not the exception but a more common phenomenon and implicate that glucocorticoids may have two faces in cancer therapy, a beneficial and a dangerous one.

NOTE from psa-rising editor: This looks like a rather chilling early confirmation of a finding in breast cancer which we were concerned might apply also to prostate cancer. See:

Widely used anti-nausea drug, dexamethasone, may interfere with breast cancer chemotherapy

by J. Strax

Vitamin E and Prostate Cancer Benefits: Not Fully Resolved

BOSTON, Dec. 20 — The U.S. Preventive Services Task Force recently recommended against routine vitamin use to prevent cancer and cardiovascular disease. The recommendation was based on a series of clinical trials that found that antioxidant supplements do not reduce the risks of these diseases.

However, just a few weeks later, results from the Alpha-Tocopherol, Beta Carotene (ATBC) Cancer Prevention Trial showed that men with high blood levels of alpha-tocopherol (a form of vitamin E) had a lower risk of prostate cancer, reports Harvard Men’s Health Watch.

“The ATBC research provides some support for vitamin E, but it’s not conclusive,” notes Dr. Harvey Simon, editor in chief of Harvard Men’s Health Watch. “Although it was a well-conducted clinical trial, its primary goal was to evaluate lung cancer. More important, all the subjects were smokers.”

A few other studies looked into this matter and found that vitamin E was not consistently beneficial in reducing the risk of prostate cancer in smokers and nonsmokers.

The relationship between vitamin E and prostate cancer has yet another complexity. Vitamin E consists of a family of chemicals known as tocopherols. Alpha-tocopherol

M. D. Anderson Cancer Center – PIKNIC – Cancer-Related Fatigue
Cancer-Related Fatigue
From PIKNIC [M D. anderson's Patient and Cargiver Support Group]: Partners in Knowledge, News in Cancer 4/3/01
From PIKNIC: Partners in Knowledge, News in Cancer 4/3/01
What Do We Know?
Cancer-related fatigue is receiving lots of attention, but because it’s an emerging field, there is still much for researchers to learn. “The state of cancer-related fatigue today is much like cancer pain was 20 years ago,” says Tito Mendoza, Ph.D., an assistant professor in M. D. Anderson’s Pain Research Group. “We know it exists and are attempting to measure it, but more studies are needed for a better understanding of who experiences it and why.”

Some tips:
* Sit down to bathe, and instead of wasting energy drying off, wear a terrycloth robe that does the job for you
* When bathing or dressing, minimize leaning down or reaching. “There are many helpful gadgets that can help you with washing yourself, getting dressed or reaching objects,” says Lathem. The Sears Self-Care catalog and the J.C. Penney Special Needs catalog offer these devices for sale.
* Do housework sitting down whenever possible, and delegate heavier tasks to others
* Take frequent rest breaks, and stop working before you become tired
* Use convenience foods that can be prepared in a microwave or other small appliances, which require less effort to use
* Prepare double portions of food and freeze half
* When shopping, make an organized list by grocery aisle to eliminate unnecessary walking
* Let a grocery store worker carry your bags to the car
* Avoid lifting your children whenever possible. When playing with them, choose activities that allow you to sit down
* Use a wheelchair or cane
“Many people won’t leave the house in a chair or with a cane, because they think it makes them look old or feeble,” says Lathem. “My advice is get over it, because wouldn’t you rather save the energy it takes to walk for something you really love to do?”