Each year the American Society for Clinical Oncology (ASCO) highlights the major advances made in the prevention and management of cancer (click here for the full text). Three advances made the list for prostate cancer in 2008 … but almost no one is acting on one of the most important of these!
ASCO divides its “advances for the year” into two groups: major advances and notable advances.
There are no major advances listed for 2008 that relate to prostate cancer, but there are three notable advances, as follows:
- The demonstration of the activity of abiraterone acetate in men with hormone-refractory prostate cancer
- The evidence that custirsen (OGX-011) plus the combination of docetaxel and prednisone was more effective than the combination of custirsen, mitoxantrone, and prednisone in reducing PSA levels and pain responses in men with hormone-refractory prostate cancer
- Explanation of the apparent link between the use of finasteride as an agent to prevent prostate cancer and the finding of a higher risk for prostate cancer in some men taking finasteride in the PCPT trial
While the first two of these “notable advances” continue to be researched, and we may be able to get the results of Phase III clinical trials of these two drugs by some time in late 2011 or early 2012, the fact that finasteride does not in fact increase the risk for prostate cancer in any patient at risk should and could be acted on now.
What is the point of spending many millions of dollars on cancer research every year if we aren’t going to act on the few really definitive results!?
In 2009 The “New” Prostate Cancer InfoLink calls upon the prostate cancer advocacy community to press for wide use of finasteride (a cheap and generically available drug) among men known to be at even slightly heightened risk for prostate cancer (e.g., anyone with a PSA level > 1.5 ng/ml who is 35 years of age or older).
Once-daily finasteride at a dose of 5 mg/d is now known to reduce risk for a diagnosis of prostate cancer by 25 percent in males over 55 years of age with minimal risk for any adverse reactions whatsoever. Updated guidelines should be issued by
- the American Society for Clinical Oncology (ASCO)
- the National Comprehensive Cancer Network (NCCN)
- the American Urological Association (AUA)
- the Society for Urologic Oncology
- the American Association of Family Pracitioners (AAFP)
- the American College of Physicians (ACP)
- the Agency for Healthcare Research and Quality (AHRQ)
recommending the use of finasteride as a preventive agent in men at potentially increased risk for prostate cancer — particularly those men with a family history of the disease and men of African-American ethnicity.
Even if these guidelines are limited to men of 55 to 74 years of age (the study population of the PCPT trial), it would certainly be better than the current miserable silence.
Filed under: Drugs in development, Prevention Tagged: | finasteride, PCPT
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ongoing trials on the
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Will this group take leadership on this? Is there a plan of action for advocates to take? Have you raised the issues with the professionals on this network. You have better access to the individuals who can make a difference than the “normal” patient advocate. If there is something that patient advocates can do then specific actions or suggestions may be helpful. I am not sure that most men would not even know where to start. A coordinated approach would be most successful. Can you supply the organization for the advocacy with suggested actions?
Prostate Cancer International is not an “advocacy organization” (yet). This is really something for Us TOO and ZERO to hang their hats on.
The bigger issue is what we can ALL agree to hammer together in 2009. We need to identify a small number of priorities. Finasteride may or may not be one of these issues … but see what I wrote in the blog under the heading “Where were you when they called?“
Please note my article entitled “The Unreachable Availability of Provenge,” which can be found on the PSA Rising web site.
[Editorial note: Dan had submitted his entire article here as a comment which was not exactly relevant to ASCO's views on important developments in 2008. However, we are more than willing to ensure that people are linked to his original article, even though we disagree with much of the article's content.]