Early results of an anti-angiogenic drug in treating advanced prostate cancer

This study investigated cabozantinib (Cometriq), an anti-angiogenic drug, in the treatment of advanced and progressing prostate cancer. Researchers report preliminary evidence for cabozantinib in reducing disease progression and cancer pain.

Tumors need to be able to grow new blood vessels in order to grow. Anti-angiogenic drugs, such as cabozantinib, are treatments that stop tumors from growing new blood vessels. This can slow cancer growth, prevent cancer spread, and even shrink tumors. Anti-angiogenic drugs have been shown to be an effective strategy for the treatment of various solid tumors. However, their role in the management of prostate cancer is still under investigation.

The aim of this study was to investigate cabozantinib in the treatment of advanced prostate cancer.

This study included 144 men with prostate cancer that had spread to the bones (bone metastasis). The cancer was no longer responding to standard hormone therapy. All men were pre-treated with chemotherapy before the study. All men then received treatment with cabozantinib, either at a high dose (100 mg) or at a low dose (40 mg). Treatment lasted for an average of 4 months.

Average overall survival (time from treatment until death from any cause) was 12.1 months in the high-dose group and 9.1 months in the low-dose group. 63% of men showed a reduction in the number of bone metastases of at least 30%. Treatment response based on bone scans was higher for the high-dose group (73%) than for the low-dose group (45%). 57% of men had a significant reduction in cancer pain (of at least 30%), regardless of dosage. The need for pain relief medications was reduced or eliminated in 55% of men. Improvements in several measures of cancer spread were also observed.

All men experienced at least one side effect with cabozantinib treatment. However, the rate of serious side effects was low. Severe fatigue was reported in 22%, high blood pressure in 14%, low red blood cells count in 13%, and blood clots in the lungs in 11% of men. 18 to 25% of men discontinued treatment due to side effects, depending on dosage.

Researchers concluded that anti-angiogenic treatment with cabozantinib can reduce bone metastases, cancer spread, and pain in men with progressing, advanced prostate cancer.

Larger randomized trials are needed to confirm these preliminary results.