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Medical Forum / Diseases and Disorders / Prostate Cancer / January 2005

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Marshall Edwards prostate cancer drug gains fast track status

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c palmer - 28 Jan 2005 09:40 GMT
Marshall Edwards prostate cancer drug gains fast track status

According to Marshall Edwards, the FDA has granted the investigational
anticancer drug, phenoxodiol, fast track status for its intended use in
patients with hormone-refractory prostate cancer.
   
27 Jan 2005, 17:05 GMT - The successful application for fast track
status was based on data derived from a phase Ib/IIa study, conducted in
two Australian hospitals, in which men with late stage
hormone-refractory prostate cancer (HRPC) were treated with the oral
dosage form of phenoxodiol as a monotherapy.
In the study, dosages of phenoxodiol ranging from 200mg to 400mg
eight-hourly had a significant effect on disease progression, as
evidenced by falls in PSA levels, and suppression of those levels for a
period of at least six months. Most of the patients remain on
phenoxodiol therapy for periods up to 18 months without evidence of
disease progression.
Of particular relevance to the FDA is that prostatic adenocarcinoma that
is refractory to both hormonal therapy and cytotoxic chemotherapy is
associated with severe morbidity and a life expectancy of less than one
year, and as such meets the criteria for a serious and life-threatening
disease.
"This decision of the FDA underpins our confidence in phenoxodiol being
an effective therapy for late-stage prostate cancer. The next step is to
take phenoxodiol into a pivotal study where we will test its ability to
halt disease progression in men with prostate cancer who have failed the
standard treatment of hormone therapy and docetaxel chemotherapy," said
Dr Graham Kelly, executive chairman of Marshall Edwards.
Phenoxodiol in intravenous form was granted fast track status by the FDA
in November 2004 for its intended use in patients with recurrent ovarian
cancer.

knowledge is power - growing old is mandatory - growing wise is optional    
"Many more men die with prostate cancer than of it. Growing old is
invariably fatal. Prostate cancer is only sometimes so."
http://community.webtv.net/PALMER_ENT/doc
Alan Meyer - 30 Jan 2005 19:12 GMT
> ...
> In the study, dosages of phenoxodiol ranging from 200mg to 400mg
[quoted text clipped - 4 lines]
> disease progression.
> ...

I can't let this just fly by without comment.

It looks like tremendous news to me.  It looks like this drug adds 18
months or more to most mens' lives after HT failure.

I just did a search on cancer.gov and couldn't find any trials of
phenoxodiol, but I presume such trials will be coming soon.

All of you guys in HT or past it might consider asking your doctor
if it will be possible to get this drug or participate in any
upcoming trial.

   Alan
J - 30 Jan 2005 19:50 GMT
> > ...
> > In the study, dosages of phenoxodiol ranging from 200mg to 400mg
[quoted text clipped - 16 lines]
> if it will be possible to get this drug or participate in any
> upcoming trial.

Me too, I think they're small cohorts, but you would have to check each trial
at various locations.
Isn't lowering the PSA tricking a person into thinking their cancer is gone.
I think I just saw a recent post saying that just because the PSA isn't
elevated, doesn't mean the person doesn't have prostate cancer?

These are early phase trials. Phase II/III measure for toxicity, right?
http://www.clinicaltrials.gov/ct/gui/show/NCT00022295
Phenoxodiol in Treating Patients With Refractory Solid Tumors
This study is currently recruiting patients.
Phase I trial to study the effectiveness of phenoxodiol in treating patients
who have refractory solid tumors.
PROJECTED ACCRUAL: Approximately 18-36 patients will be accrued for this
study.
Record last reviewed:  September 2001

http://www.clinicaltrials.gov/ct/gui/show/NCT00091377
Phenoxodiol Combined With Either Cisplatin or Paclitaxel in Treating Patients
With Recurrent Late-Stage Ovarian Epithelial, Fallopian Tube, or Primary
Peritoneal Cancer
This study is currently recruiting patients.
Randomized phase I/II trial to compare the effectiveness of combining
phenoxodiol with either cisplatin or paclitaxel in treating patients who have
recurrent late-stage ovarian epithelial cancer, fallopian tube cancer, or
primary peritoneal cancer that has not responded to treatment with drugs such
as paclitaxel, docetaxel, cisplatin, or carboplatin.

http://psa-rising.com/med/chemo/phenoxodiol04.htm
Oral phenoxodiol reported to slow disease progression in late stage prostate
cancer patients

http://www.news-medical.net/?id=7531
Phenoxodiol gets fast track status for its intended use in patients with
hormone-refractory prostate cancer
Posted By: News-Medical in Pharmaceutical News
Published: Wednesday, 26-Jan-2005
The successful application for fast track status was based on data derived in
a Phase Ib/IIa study, conducted in two Australian hospitals, in which men
with late stage HRPC were treated with the oral dosage form of phenoxodiol as
a monotherapy.

J
Stephen Jordan - 30 Jan 2005 20:45 GMT
On January 30, J wrote, in pertinent part:

> Isn't lowering the PSA tricking a person into thinking their cancer is gone.

I would hope that our medics are above such chicanery.

> I think I just saw a recent post saying that just because the PSA isn't
> elevated, doesn't mean the person doesn't have prostate cancer?

Dunno about other posts, but it is a fact that low PSA does not
necessarily mean no or minimal PCa. The more advanced the tumor, the
less "differentiated" are the cells, and the less PSA they manufacture.

My case is illustrative. My first biopsy diagnosed a Gleason 9, yes,
*nine* tumor in *five of six specimens* from one side of my prostate.
But my PSA, while elevated at 5.7, was not terribly high. There was
little correlation between PSA level and the state of my cancer. I won't
go into the implications here. Suffice to say that my case is very
high-risk.

So what to do? I recommend tracking PSADT and PSAV (doubling time and
velocity), plus, of course, DRE's.

Regards,

Steve J
__
"No man is an Island, entire of itself; every man is a piece of the
Continent, a part of the main; if a clod be washed away by the sea,
Europe is the less, as well as if a promontory were, as well as if a
manor of thy friends or of thine own were; any man's death diminishes
me, because I am involved in Mankind; And therefore never send to know
for whom the bell tolls; It tolls for thee."
-- John Donne
Alan Meyer - 30 Jan 2005 21:19 GMT
> ...
> Isn't lowering the PSA tricking a person into thinking their cancer is gone.
> I think I just saw a recent post saying that just because the PSA isn't
> elevated, doesn't mean the person doesn't have prostate cancer?

Good question.  The report quoted by Curtis said, "Most of the patients
remain on phenoxodiol therapy for periods up to 18 months without
evidence of disease progression."

Does that mean that no PSA evidence, or no evidence at all?

I'm guessing the latter.  I thought I read somewhere that men typically
die 12 months after HT failure.  So if the majority of these patients
have no evidence of disease progression at 18 months, that really
means they're doing well, not just lowering their PSA.

But I'm no authority on that.

> These are early phase trials. Phase II/III measure for toxicity, right?

No, Phase I tests for dosage and toxicity.  Phase II tests for efficacy.
Phase III tests larger scale application.

I see why I didn't find these trials on cancer.gov.  The first is a trial for
"unspecified adult solid tumor" - which means that prostate cancer and
other cancers qualify.  I needed to do a broader search than I did.

Others are not in the U.S., or not related to prostate cancer.

Thanks for posting these.

   Alan

> http://www.clinicaltrials.gov/ct/gui/show/NCT00022295
> Phenoxodiol in Treating Patients With Refractory Solid Tumors
[quoted text clipped - 31 lines]
>
> J
J - 30 Jan 2005 21:54 GMT
> > These are early phase trials. Phase II/III measure for toxicity, right?
>
> No, Phase I tests for dosage and toxicity.  Phase II tests for efficacy.
> Phase III tests larger scale application.

In Phase I trials, researchers test a experimental drug or treatment in a small
group of people (20-80) for the first time to evaluate its safety, determine a safe
dosage range, and identify side effects.

In Phase II trials, the experimental study drug or treatment is given to a larger
group of people (100-300) to see if it is effective and to further evaluate its
safety. (Note from me: they switch words here from toxicity to "further evaluate
safety").

In Phase III trials, the experimental study drug or treatment is given to large
groups of people (1,000-3,000) to confirm its effectiveness, monitor side effects,
compare it to commonly used treatments, and collect information that will allow the
experimental drug or treatment to be used safely.

In Phase IV trials, post marketing studies delineate additional information
including the drug's risks, benefits, and optimal use.

So they're still looking for "safety" even in Phase IV
I don't start doing "rah rah's" until after a Phase III shows good results. And/or
we can obtain more details about how many dropped out, passed away (from cancer or
other causes), etc.

> I see why I didn't find these trials on cancer.gov.  The first is a trial for
> "unspecified adult solid tumor" - which means that prostate cancer and
> other cancers qualify.  I needed to do a broader search than I did.

I will watch with interest,
Thanks Alan,
J

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