Quale sarà il ruolo di Denosumab: la 1° linea di trattamento, l’associazione all’ac....
-
Upload
valeriano-giannini -
Category
Documents
-
view
214 -
download
1
Transcript of Quale sarà il ruolo di Denosumab: la 1° linea di trattamento, l’associazione all’ac....
Quale sarà il ruolo di Denosumab: la 1° linea di trattamento, l’associazione all’ac. zolendronico o la 2° linea ?
G. CartenìDirettore U.O.S.C. di Oncologia Medica A.O.R.N.A. Cardarelli Napoli
GESTIONE DELLE METASTASI OSSEE
Skeletal Complication Risk: Incremental Benefits in Prostate
Cancer
No bisphosphonate 49% risk at 2 yrs
Zoledronic ~ 20% risk reduction Denosumab
Additional ~ 12% risk reduction
Denosumab Additional 18%
time to first SRE increase
Saad F, JNCI, 2004, Fizazi K, Lancet, 2011
+
Abiraterone post-docetaxel does delay SREs
Logothetis et al. Lancet Oncology, 2012
4.7 months of difference
JS De Bono, ASCO, 2012
Enzalutamide post-docetaxel does delay SREs
3.4 months of difference
Pre-planned analysis
Direct Androgen dependent Interactions in Bone disease
Hypothetic interactions.
Stroma
> Angiogenesis
Osteoblast
Tumor Cell
Osteoclast
Migrationproliferation
survival
> apoptosis
Migrationproliferation
survival
Wiren KM, Bone, 2006; Eisermann K, Mol Cancer, 2013
ANDROGEN
Dayyani F et al. JNCI J Natl Cancer Inst 2011;103:1665-1675
Inhibition of androgen pathway in cancer cells and indirect
effects on microenvironment