MDV3100 vs. abiratetone acetate: the analysts’ perspectives

Some readers may be interested in in reading a commentary by John Carroll on the FierceBiotech web site, where he discusses whether MDV3100 is going to be able to “match up” to abiraterone acetate — always assuming that MDV3100 can also show a survival benefit in men with metastatic, castration-resistant prostate cancer (mCRPC).

We will let the article stand for itself, since we prefer to wait and see what the results of Phase III clinical trials actually show before we get into the issues of how to use specific drugs in clinical practice. The one thing we do think definitely gives MDV3100 a very real “edge” is the fact that it doesn’t have to be taken in combination with an corticosteroid like prednisone that is itself associated with a well-understood series of side effects (particularly those associated with high blood pressure).

From a clinical point of view, it seems likely that MDV3100 will have to show at least the same 4-month survival benefit as abiraterone + prednisone in men with mCRPC and a clearly better safety profile if it is to become the first-line choice for the urologic oncology and the oncology communities in the treatment of docetaxel-refractory/resistant mCRPC. However, the real battle is going to come when data is available for these and other new therapeutics much earlier in the disease process, and well before the use of chemotherapy is being considered.

2 Responses

  1. Besides its effectiveness and safety profile, the other issue that will determine how MDV3100 fares vis-a-vis Zytiga (abiraterone) is the cost. I started on Zytiga yesterday. My 30-day supply of it cost $5,281, which works out to about $176 per day, which makes it less expensive than Provenge and Jevtana, but still a considerable expense. Would that MDV3100 would come out a little less expensive.

  2. Why is the standard for evaluating either of these drugs comparative instead of objective? What difference does it make to the patient whether MDV3100 only diplays half the duration of Zytiga or that it risks twice the side effects, if he can get a few more progression-free months? I have been on Zytiga for 3 weeks and my expectations are not terribly hopeful since I enjoyed 18 progression-free months on ketoconazole, which has lowered the likelihood that Zytiga will work for me, and the early returns are unpromising. PSA rose from 8.3 to 15.2 in the first 2 weeks of treatment. Would I like my oncologist to have a weaker but still viable possibility of MDV3100 in her quiver? You bet your sweet … !

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