HER2 Inhibitors included in our survey felt that they were very likely to be using cabazitaxel in their clinical practice within the next yea with a further 5 stating that this was a possibility. These dings are unsurprising given the impressive phase III study data reported for this age which showed that treatment with cabazitaxel was associated with a signi ant improvement in overall survival and progression-free survival pared with mitoxantrone in men with mCRPC whose disease had progressed during or after docetaxel-based therapy . Moreov as cabazitaxel is already licensed for mCRPC in the USA and has received European Union licence approval , it is very likely that cabazitaxel will be the standard second-line chemotherapy option in the UK for patients with mCRPC.
Other agents identid in our survey as likely to have a big impact on UK clinical practice over the next years were abiraterone acetate and MDV. Abiraterone acetate is a non-steroidal ester that selectively and irreversibly inhibits both 7 -hydroxylase and the -lyase function of CY 7 a cytochrome involved in the production of dehydroepiandrosterone and androstenedione . Encouraging anti-tumour activity has been reported with abiraterone acetate at a dose of mg/day in various CRPC populations across several phase II studies . More recent dings from a phase III study showed that abiraterone acetate plus low-dose prednisone signi antly improved overall surviva time to PSA progressio FK-506 progression-free survival and PSA response pared with placebo in men with mCRPC who had progressed after docetaxel-based therapy . Based on these da abiraterone acetate recently received US Food and Drug Administration approval for use inbination with prednisone for the treatment of patients with mCRPC who have received prior chemotherapy containing docetaxel .
Abiraterone has now received a European License approval from the EMA . In additi a second phase III study of abiraterone acetate plus low-dose prednisone in chemotherapy-naive men with mCRPC is ongoing . Hen it is likely th once availab there will be a signi ant and rapid uptake in the use of abiraterone acetate in the in patients who have previously received chemotherapy and pending licence approvals in the futu also in chemotherapy-naive patients. Although MDV is at a slightly earlier stage of clinical developmentpared with abiraterone aceta available data are promising and suggest that this agent is also likely to have a signi ant impact on UK clinical practice within the next years. MDV is an androgen receptor antagonist that lacks agonist activity and works by preventing nuclear translocation of the androgen receptor and its binding to DNA . A phase I “II dose escalation stu conducted in men with progressive mCR showed that MDV was well tolerated up to a dose of with encouraging anti-tumour activity indicated . As a resu MDV at a dose of mg/day is being evaluated in a phase III study in men with mCRPC who have previously received docetaxel-based therapy . A second phase III study in allegiance chemotherapy-naive men with progressive mCRPC is also ongoi with results anticipated in September . Howev there may be potential challenges in interpreting dings from this study because of the possibility of the placebo arm crossing over to receive abiraterone acetate.