Today’s news reports address studies on:
- Screening and its impact on prostate cancer-specific mortality
- Naproxen + calcitriol as first-line therapy for recurrent prostate cancer
Roobol et al. have reanalyzed data from the European Randomized Study of Screening for Prostate Cancer (ERSPC) to take account of patient non-attendance and contamination as a consequence of including men who did have PSA tests but who were in the control arm of the study. Based on this reanalysis, they conclude that, “PSA screening reduces the risk of dying of PCa by up to 31% in men actually screened. This benefit should be weighed against a degree of overdiagnosis and overtreatment inherent in PCa screening.” This is an interesting reanalysis of the data, but it would be hard to state that it “proves” that screening reduces the risk of dying of prostate cancer by 31 percent.
Srinivas and Feldman have reported data from a small trial of naproxen and high-dose calcitriol in 21 patients with early, recurrent prostate cancer. The objective was to see if this form of treatment is effective in safely delaying the progression of prostate cancer prior to the need for hormone therapy. The patients received calcitriol (DN101, Novacea) (45 μg/week) and naproxen (375 mg twice daily) for 1 year. They were followed using serum PSA levels as well as imaging studies. Four patients met criteria for progression, with a PSA doubling time (PSADT) that decreased while on therapy; 14 patients had a prolongation of PSADT compared to baseline. The authors concluded that weekly calcitriol and daily naproxen is well tolerated by most patients and prolongation of PSADT was achieved in 75 percent of patients on study.
Filed under: Diagnosis, Drugs in development, Risk | Tagged: calcitriol, mortality, naproxen, screening
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Am I reading this right?
Aren’t naproxen + calcitriol the same chemicals as Aleve and vitamin D3?
Naproxen is indeed marketed as Aleve, and calcitriol is a formulation of vitamin D3. I just report the data!
“I just report the data!” … Yeah — right ….
The study reports a prolongation of PSADT was achieved in 75 percent of patients on study. Can someone please tell us what prolongation of PSADT means in more common terms? I am guessing that this is not bad but if good, how good?
Dear Larm:
If one’s PSA doubling time (PSADT) is, say, 6 months prior to treatment, then any period longer than that (7 months; 11 months; 18 months) would be prolongation. The greater one’s PSA doubling time the better. So a PSADT of 15 months is generally considered to be associated with minimal risk of serious disease progression.