The prostate cancer news for Thursday, July 30

News items today are focused on information about:

  • a new way of approaching treatment of hormone-refractory disease
  • the initial clinical trials of a new drug candidate in hormone-refractory patients
  • the association between hospital and surgeon volume and patient outcomes after radical prostatectomy.

According to a report in Science Daily, “Researchers at the University of Adelaide have developed a novel approach to treating advanced prostate cancer that could be more effective with fewer side effects.” We should immediately point out that what these researchers have actually done is test a combination of currently available drugs in a prostate cancer cell model in a Petri dish. This means there is a way to go before we would know if this combination of drugs actually worked in men with hormone-refractory or any other form of prostate cancer. However, the theory behind the thinking is certainly of interest.

Also on the drug development front, Hollis-Eden Pharmaceuticals has announced the initiation of a Phase I/II clinical trial of its investigational, oral drug candidate Apoptone™ (also known as HE3235) in patients who have failed hormone therapy and at least one round of chemotherapy treatment. Full details about this trial are available in the company’s media release and on the web site.

Last, but possibly not least, Wilt et al. have analyzed data on the association between hospital and surgeon with respect to volume and patient outcomes of radical prostatectomy (RP). They searched available databases to identify controlled studies published in English from 1980 to November 2007. A total of 17 original investigations reported patient outcomes in categories of hospital and/or surgeon annual number of RPs, and met inclusion criteria. Hospitals with volumes above the average (43 RPs per year) had lower surgery-related mortality and morbidity. Teaching hospitals had an 18 percent lower rate of surgery-related complications. Surgeon volume was not significantly associated with surgery-related mortality or positive surgical margins. However, the rate of late urinary complications was 2.4 percent lower and the rate of long-term incontinence was 1.2% lower for each 10 additional RPs performed by the surgeon annually. Length of stay was lower, corresponding to surgeon volume. Wilt et al conclude that, “Higher provider volumes are associated with better outcomes” after RPs. The “New” Prostate Cancer InfoLink is not at all surprised by these results. We believe patients should seek out surgeons who carry out a minimum of 100 RPs a year, and for whom prostate cancer surgery is the dominant proportion of their clinical practice. The hospital where they are operating is therefore unlikely to be a relevant consideration.

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