Modra Pharmaceuticals is working on an oral version of docetaxel, the main drug used in chemotherapy for prostate and a number of other cancers. A patient will take two pills on one day, wait a week, then do it again, for however many weeks are prescribed. It can be done at home. They claim that it will improve efficacy, significantly reduce side effects, greatly lower the cost, and greatly reduce the inconvenience to patients.
They completed a Phase I trial with prostate cancer patients and apparently did well enough that they say that they've started a Phase II with breast cancer patients and are planning a Phase IIb clinical trial for metastatic castration resistant prostate cancer - for which they say they have FDA approval.
I wonder if this could lead to a low dose treatment that could be used long term. I know of 2 people whose MO gave them 6 months....about 10 years ago...and they are both doing well by having low dose 'maintenance' treatments of chemo every week or two. One has St4 colon cancer, mets throughout his body and organs, the other has St 3 or St 4 breast cancer.
That's an interesting idea. I suspect that the cost and inconvenience of the procedure is a barrier to low dose maintenance chemo and maybe this would overcome it. There's also a lot of research on reducing resistance to docetaxel that might help with this.
It might well reduce the cost to insurers but as a drug currently covered under part B the oral version would shift the burder for medicare recipients to part D and you can bet the cost will be substantial..... My biggest worry in Tx of Prostate Ca is that most of the drugs currently offered in MD's offices are going to shift to oral and then exceed my ability to pay..... many manufacturers help programs will _ not_ work with patients who have part D....a real conundrum...
I read an interesting interview with Dr. Tanya Dorff On Chemotherapy For Prostate Cancer today. Its up on Prostrapedia (Snuffy Myers web site). Also on Grand Rounds in Urology. It discusses many aspects of Chemo and how to make it better and improve Q o Life.
Interesting. I can understand absorption into the vascular system via the stomach lining; trying to wrap my head around absorption into the lymphatic system as well......
One of the difficulties that I have, like the current protocol for metastatic breast cancer, is that I also received infusions of Taxotere and Adrimyacin. I know how these two drugs work.
Looking forward to reading trial results. Thanks Alan for sharing.
If the general reaction to oral docetaxel is anything like as positive as the reaction has been in this one forum, Modra Pharmaceuticals has come up with a popular idea. Let's see if their science works out as well as their theories. And won't it be wonderful if they make the drug available at a reasonable price?
If the drug works, I hope the FDA will fast track it. It normally takes years for new drugs to work their way through clinical trials and approvals.
Good question. It's one for which I don't know the answer. I do believe that manufacturing cost is small part of the price, but that costs of R&D and clinical trials are high. However I also know that the same drug companies sell the same drugs in other countries at prices below the prices they charge Americans. And I know that, legally, a drug company can charge anything they want. I believe most of them very finely analyze how high they can set the price without losing more patients and insurers because it's too high - then they go for a balance that provides the greatest expected profit.
Drug company pricing is opaque. I have NEVER seen a drug company break down the specific costs built into their drug prices. I also don't trust their overall cost breakdowns, for example how much corporate money they spend on R&D, "education", and so on because I know there have been proven cases where these numbers were doctored.
A good source I've seen on this subject is Marcia Angell's 2005 book The Truth About The Drug Companies - How They Deceive Us And What To Do About It.
Good, they finally coming up with oral form and the next probably targeted delivery via nanoparticles with precision guidance and activation on demand (magentic, photonic or whatnot).
Veru Pharmaceuticals is testing another oral tubulin inhibitor which is comparing to taxanes inhibits both a- and b- tubulin and has lighter side effects footprint.
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Anyone prescribe Metformin for prostate cancer not for diabetes? 
Nivolumab+docetaxel trial
