Thursday’s news: December 11, 2008


There are two significant prostate cancer reports in the news today.

In the first, Millikan et al. provide data from a Phase III clinical trial of three 8-week cycles of ketoconazole and doxorubicin alternating with vinblastine and estramustine, given in addition to standard androgen deprivation, in patients with previously untreated metastatic prostate cancer to test the hypothesis that this form of treatment would delay the appearance of castrate-resistant disease. They show that in fact there was no survival benefit to this form of therapy, and that patients receiving this treatment regimen had significant problematic side effects. The authors conclude that there is “no role for ketoconazole and doxorubicin alternating with vinblastine and estramustine before emergence of a castrate-resistant phenotype.”

The second study is a report on the use of complementary and alternative medicines (CAMs) following treatment for localized disease. In this study, Porter et al. report that CAM usage decreased by about 25 percent within 2 years after initial treatment. Men most frequently cited beliefs that discontinued CAM therapies were ineffective, generally unsuitable, or harmful, despite a lack of objective criteria for making these judgments. In their conclusionds, the authors state that, “Although lack of confidence in CAMs effectiveness characterized all discontinuations, higher effort therapies tend to be discontinued more quickly than lower effort therapies.”

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