Dr. Gomella on Neoadjuvant Hormonal Therapy Plus Zytiga

Leonard G. Gomella, MD
Published: Wednesday, May 16, 2012

Leonard G. Gomella, MD, Bernard W. Godwin Jr. professor of prostate cancer and chairman of the Department of Urology, director of Clinical Affairs, Jefferson Kimmel Cancer Center, discusses the addition of abiraterone acetate (Zytiga) to hormonal therapy before the surgical removal of the prostate.

A randomized Phase II study to be presented at ASCO showed that six months of neoadjuvant hormonal therapy plus abiraterone acetate before radical prostatectomy in men with very high-risk disease eliminated, or nearly eliminated, cancer in one-third of men with localized high-risk cancer.

Gomella says the trial is very interesting preliminary work, but it should be remembered that there was a tremendous amount of interest in neoadjuvant hormonal therapy using LHRH analogs, with or without an antiandrogen agent, going back to the 1990s. While that data looked promising pathologically, when patients were followed for a longer period of time, it showed that their recurrence rates were the same as those not treated.

While the Phase II study is important and has very positive early results, Gomella says only time will tell if the PSA recurrence rate will be improved, if additional radiation therapy will be necessary, or if patients will fail therapy.

<<< View more from the 2012 ASCO Conference

Leonard G. Gomella, MD, Bernard W. Godwin Jr. professor of prostate cancer and chairman of the Department of Urology, director of Clinical Affairs, Jefferson Kimmel Cancer Center, discusses the addition of abiraterone acetate (Zytiga) to hormonal therapy before the surgical removal of the prostate.

A randomized Phase II study to be presented at ASCO showed that six months of neoadjuvant hormonal therapy plus abiraterone acetate before radical prostatectomy in men with very high-risk disease eliminated, or nearly eliminated, cancer in one-third of men with localized high-risk cancer.

Gomella says the trial is very interesting preliminary work, but it should be remembered that there was a tremendous amount of interest in neoadjuvant hormonal therapy using LHRH analogs, with or without an antiandrogen agent, going back to the 1990s. While that data looked promising pathologically, when patients were followed for a longer period of time, it showed that their recurrence rates were the same as those not treated.

While the Phase II study is important and has very positive early results, Gomella says only time will tell if the PSA recurrence rate will be improved, if additional radiation therapy will be necessary, or if patients will fail therapy.

<<< View more from the 2012 ASCO Conference


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