Prostate Cancer Coverage Extends Beyond Clinical Studies

OncLive Chairman,

Mike Hennessy

It seems like the feature stories and meetings coverage this month singularly revolve around prostate cancer. That’s not by accident—prostate cancer is garnering interest in a lot more areas than just clinical studies.

In our feature story, “BMS, Bavarian Nordic Forge $1 Billion Prostvac Deal,” Associate Editor Tony Hagen covers the manufacturing and distribution arrangement between Bristol-Myers Squibb and Bavarian Nordic for the immunotherapy Prostvac. Prostvac is a pox viral vaccine expressing prostate-specific antigen. The agent has shown efficacy as both a monotherapy and in combination with other therapies.

Under terms of the deal, Bavarian Nordic will receive an initial payment of $60 million and the potential for up to $975 million in milestone and upfront payments. BMS receives exclusive rights to license and commercialize the immunotherapy, which is in phase III development for the treatment of asymptomatic or minimally symptomatic metastatic castration-resistant prostate cancer (mCRPC).

In a slightly more personal take, we profile the persistence and tenacity of Thomas Neville, PhD, an analyst formerly with the US Department of Energy. After a positive prostate cancer diagnosis in 2002, Neville embarked on a journey to understand the results of his biopsy and to determine the best course of action. Initially, he discovered great variability associated with treatment—some evidence supported radical prostatectomy, some supported radiation, and some supported active surveillance.

Trying to make sense of the treatment possibilities led him to propose the idea of “smart screening,” that is, using dynamic analysis of PSA results to make an informed decision, which could be adopted by other patients. Instead of relying on a single PSA test to make a decision on the course of treatment, Neville proposed combining PSA analysis patterns culled from Veterans Affairs data sets with many other factors, such as age, race, family history, digital rectal exam result, and prostate volume. His exercise in data analysis gives a fuller, comprehensive picture about prostate cancer that can lead to decreased morbidity, reduced biopsies, and savings in healthcare costs.

Meetings coverage in this issue focuses on the 2015 Genitourinary Cancers Symposium and the 8th Annual Interdisciplinary Prostate Cancer Congress® and Other Genitourinary Malignancies. The GU conference resulted in more than 640 abstracts submitted by researchers worldwide and focused on the theme, “Integrating Biology Into Patient-Centric Care.” The data that caused the largest stir at the meeting were results from the phase III ASSURE trial, the first study to evaluate the efficacy of multi-targeted VEGF inhibitors in the adjuvant setting for patients with locally advanced renal cell carcinoma (RCC) at high risk of recurrence.

Standard therapy in patients with resected nonmetastatic disease is close observation, with scans performed at regular intervals. The ASSURE trial was carried out to determine if either of these VEGF inhibitors could provide benefit for patients with resected primary disease in the adjuvant setting. Patients were randomized in a 1:1:1 ratio to receive one of the two VEGF inhibitors or placebo for one year.

The results demonstrated that neither sorafenib nor sunitinib offered benefits above and beyond those of placebo in the adjuvant setting. Overall survival was shown to be similar among all 3 arms, reported Naomi B. Haas, MD, associate professor, Abramson Cancer Center of the University of Pennsylvania.

At the IPCC conference, Leonard Gomella, MD, kicked off the meeting by elucidating the PSA screening debate, boiling down the decision whether to screen to “using common sense, shared decision making, and choosing the right patients to screen.” Comprehensive presentations of the latest studies involving immunotherapies in bladder and renal cancer kept oncologists, urologists, and other clinicians up-to-date on this emerging treatment regimen.