Advanced Prostate Cancer

Tasquinimod

New study [1].

I don't believe Tasquinimod has come up before, though there are published trial results going back 6 years.

Wiki [2]: "Tasquinimod targets the tumor microenvironment and counteracts cancer development by inhibiting angiogenesis and metastasis and by modulating the immune system."

Carducci [Hopkins] (2013) [3]:

"Tasquinimod, has a somewhat poorly understood mechanism of action. It is thought to exert an antiangiogenic effect through the inhibition of myeloid-derived suppressor cells, key to the support of an angiogenic environment, and down-regulation of hypoxia-inducible factor-1α. A phase II trial randomizing men to tasquinimod versus placebo revealed a median progression-free survival advantage in the experimental arm (7.6 vs. 3.3 months with placebo ...). Based on these encouraging phase II results, a randomized, double-blind, placebo-controlled trial in men with metastatic castration-resistant PCa was launched. That trial is powered for a primary endpoint of progression-free survival and is expected to enroll 1200 men."

Carducci (2016) [4]:

In all, 1,245 patients were randomly assigned to either tasquinimod (n = 832) or placebo (n = 413) between March 2011 and December 2012 at 241 sites in 37 countries. ...

"Estimated median {radiographic progression-free survival} by central review was 7.0 months ... with tasquinimod and 4.4 months ... with placebo ...

"Median {overall survival} was 21.3 months ... with tasquinimod and 24.0 months ... with placebo ..."

Another example of improved radiographic progression-free survival without improved overall survival.

The new Phase II study involved a dozen countries. "A total of 219 patients were screened and 144 patients randomized. The median duration of treatment was 18.7 weeks (range: 0.6-102.7 weeks) for the tasquinimod arm". These were mCRPC men "not progressing during first-line docetaxel-based therapy."

"The median OS was not reached because only 14 deaths occurred by the cut-off date."

"Maintenance tasquinimod therapy significantly reduced the risk of {radiographic progression-free survival} by 40%."

-Patrick

[1] ncbi.nlm.nih.gov/pubmed/290...

[2] en.wikipedia.org/wiki/Tasqu...

[3] ncbi.nlm.nih.gov/pubmed/233...

[4] ncbi.nlm.nih.gov/pubmed/272...

3 Replies
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Hi Patrick,

Tasquinimod looks promising in various ways. But does the finding in the largest study, last year, that overall survival was longer for those on placebo than on tasquinimod destroy its desirability, pending further research?

Thanks,

Neal

Reply

Neal,

Assuming that a man has exhausted all treatments before Taxotere, but had a response to that, it appears that Tasquinimod might be a useful maintenance chemo.

Perhaps it has other roles too?

The Phase III study is troubling. A reminder that time bought to delay biochemical recurrence might be at the price of more aggressive disease later. Pharma has to concentrate on combo drugs that close off the bolt holes used in response to the main drug. It's in their interest. More lucrative to have a drug used for years, rather than months.

-Patrick

1 like
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You make all kinds of sense to me, Patrick. I hope Pharma is listening!

Neal

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