The combination of Avastin® (bevacizumab), Thalomid® (thalidomide), and Taxotere® (docetaxel) is highly active in hormone-refractory prostate cancer, according to the results of a study published early online in the Journal of Clinical Oncology.
The prostate is a male sex gland responsible for producing fluid that forms semen. It is located below the bladder, in front of the rectum, and surrounds the urethra. Prostate cancer occurs when the cells in the prostate gland grow out of control.
Prostate cancer is a hormonally sensitive disease that can be controlled for long periods with androgen deprivation therapy (ADT). When prostate cancer stops responding to this treatment, it is referred to as hormone-refractory prostate cancer. Metastatic, androgen-independent (or hormone-refractory) prostate cancer is a challenging form of the disease to treat because the cancer has spread to distant sites in the body and does not respond to treatment with hormonal therapy.
Historically, Taxotere has been the single most effective agent for the palliative treatment of hormone-refractory prostate cancer (HRPC); however, most patients ultimately fail to respond. Previous studies have shown that the combination of Thalomid plus Taxotere has anti-tumor activity in HRPC. In addition, studies have shown that the combination of Avastin plus Taxotere has anti-tumor activity in this population. As a result, researchers from the National Cancer Institute theorized that the combination of all three agents would have substantial anti-tumor activity.
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They first tested the combination of Avastin/Thalomid/Taxotere in a mouse model and found significant activity. Next, they conducted a clinical trial that involved 60 patients with HRPC. Ninety percent of patients who received the combination therapy experienced PSA declines of 50% or more. The median time to progression was 18.3 months and the median overall survival was 28.2 months.
The researchers concluded that the combination of Avastin/Thalomid/Taxotere is a highly active combination for HRPC and doubles the average predicted survival time. The toxicities were manageable, and further study is warranted.
 Ning YM, Gulley JL, Arlen PM, et al. Phase II trial of bevacizumab, thalidomide, docetaxel, and prednisone in patients with metastatic castration-resistant prostate cancer. Journal of Clinical Oncology[early online publication]. March 22, 2010.
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