A Statistical Nightmare – Comparing the Efficacy of Zytiga & Xtandi In the Pre-Chemo Setting

Based on the assumption that Enzalutamide (Xtandi) is approved for use in men with castrate resistant metastatic prostate cancer (advanced prostate cancer or mCRPC) who have not had prior chemotherapy, pretty much a foregone conclusion based on the extraordinary phase III Prevail Trial results, including a statistically significant survival advantage of 2.2 months with a 30% reduction in the risk of death, hazard ratio = 0.70 (p=0.0001); 81% reduction in the risk of radiographic progression or death, hazard ratio = 0.19 (p=<0.0001).    Since the trial was stopped early because it achieved statistical significance it never achieved a valid survival advantage [...]

StartACure – Now is the Time to Step Up and Start A Cure for Prostate Cancer

Today’s post will be a little admonishment of you, my loyal readers. So, please be open-minded and think about what I have to say to you. A number of months ago I mentioned the new prostate cancer research-funding project we have embarked upon, Start A Cure (www.StartACure.com). For those of you who might have missed my announcements and my follow up many mentions, Start A Cure is what is referred to by our children and grandchildren as a crowdfunding site. The slightly tech savvy among us might know of the web pages KickStarter and Indigo, these are general crowdfunding sites [...]

Great Video Worth Spending the 9 Minutes Required Discussing Provenge and the Use of Zytiga (Along with Prednisone)

OncLive Peer Exchange has put out a video about the issues that most concern many of us surrounding the use of Provenge (Sipuleucel-T).   The video is a 9 minute discussion with Drs. Raoul Concepcion (moderator), Leonard Gomella, Lawrence Karsh, Evan Yu and Mark Scholtz.  They examine the concern that so many men with advanced prostate cancer express about the effectiveness of Provenge in light of the failure of Provenge to control either PSA or disease progression based on scans. The panel also included an interesting mention from Dr. Scholtz about his practices use of Inspra (a blocker of aldosterone binding [...]

Who will respond to Zytiga (Abiraterone) and Xtandi (Enzalutamide)?

We have many new drugs that have been recently approved to treat advanced prostate cancer. Two of these drugs are abiraterone (Zytiga) and enzalutamide (Xtandi). These drugs offer new hope to men with advanced prostate cancer after the cancer has become resistant to hormone therapies (called "castration-resistant prostate cancer"). These drugs are a real breakthrough, however about 20% of men prescribed these drugs do not respond to these drugs (i.e. PSA does not go down, tumors do not shrink). Currently we don’t know why some men respond to these drugs, while others are resistant. Knowing in advanced if a man [...]