-- Leading Experts Challenge Physicians to Re-Think Treatment Options
MACCLESFIELD, England, Nov. 1 /Xinhua-PRNewswire/ -- 1st November 2006: A
survey of more than 330 oncologists and urologists from around the world
reveals a lack of awareness and understanding of the clinical benefits of
Combined Androgen Blockade (CAB) therapy for the management of advanced
prostate cancer (1). Following a review of the survey findings, an
international panel of experts calls for physicians to re-consider the
benefits of CAB as a treatment option, proven effective in extending survival
and delaying disease progression in men with advanced prostate cancer.
(2,3,4,5)
Out of fashion, but effective
The survey explored the use and perceptions of CAB for the treatment of
men with advanced prostate cancer. The majority of respondents (71%) believes
that CAB should be used more often and in more patients, yet when exploring
factors that could encourage increased CAB usage, 66% cited the need for
clinical evidence(*1). The panel attributes this misconception regarding the
need for evidence to CAB’s low profile amongst physicians.
Mr David Gillatt, a panel member and Consultant Urologist at Southmead
Hospital, Bristol, UK commented that: "In this era of targeted therapies and
evolving innovations in healthcare and specifically prostate cancer, it is
the new drugs that dominate proceedings at medical meetings and secure
interest. We must not allow the benefits of established and proven
treatments, such as CAB, to be overlooked to the detriment of patient care."
Non-CAB prescribers: perception of clinical evidence
The survey revealed that 79% of non-CAB prescribers attribute the need
for more clinical evidence demonstrating the benefits of CAB as a reason for
not utilising the treatment option(*1). Speaking on behalf of the panel,
Professor of Surgery at the Sunnybrook Health Services Centre, University of
Toronto, Canada, Professor Laurence Klotz addressed the belief that there is
a lack of clinical evidence noting that: "Such misconceptions are a barrier
to the use of combined hormonal therapy. The evidence suggests that there may
be significant benefits from the use of combination therapy. The addition of
CASODEX (bicalutamide) 50mg to an LHRH agonist in patients at high risk for
prostate cancer mortality could reduce the rate of prostate cancer death by
20% compared to castration therapy alone."
Dr Heather Payne, a member of the expert panel and Consultant in Clinical
Oncology, Meyerstein Institute of Oncology, University College Hospital,
London, UK added that: "The evidence for CAB exists but we need to challenge
physicians to re-consider this evidence to ensure that patients with advanced
prostate cancer have access to this treatment which offers the greatest hope
for extending survival."
Influence of current clinical guidelines
The survey also explored physicians’ views on current clinical
guidelines for the management of advanced prostate cancer with CAB, and
showed that more than half of the respondents believe that the guidelines are
too numerous, lack clarity or are outdated (52%).(1)
Dr David Castro-Diaz, a panel member and Consultant Urologist, Hospital
Universitario de Canarias, Spain, noted that: "Guidelines regarding hormonal
therapy remain general to allow a wide interpretation of the recommendations
but also need to provide increased clarity regarding the present indications
of combination therapy to physicians."
Putting evidence into practice
"The survey findings clearly indicate the need for physicians to re-
assess the benefits of combination therapy. We need to shift some of the
current perceptions and subsequent treatment practices that are employed
around the world and ensure that we are providing optimum patient care for
men with advanced prostate cancer" concluded Dr Heather Payne.
About the study:
-- The results of the research study, conducted by AstraZeneca, were
analysed by First Line Research, an independent market research company
-- A total of 339 complete responses were generated from oncologists and
urologists worldwide
-- The survey was available online and also made available at medical
congresses
-- A panel of five oncologists and urologists were invited by AstraZeneca
to review and approve the survey questions and analyse the subsequent
findings identified. The panel is as follows:
-- Professor Hideyuki Akaza, Professor of Urology and Chairman, Clinical
Medicine, Post-graduate University of Tsukuba, Tsukuba-City, Ibaraki,
Japan
-- Dr David Castro-Diaz, Hospital Universitario de Canarias, Spain
-- Mr David Gillatt, Consultant Urologist, Southmead Hospital, Bristol, UK
-- Professor Laurence Klotz, Professor of Surgery, Sunnybrook Health
Sciences Centre, University of Toronto, Ontario, Canada
-- Dr Heather Payne, Consultant in Clinical Oncology, Meyerstein
Institute of Oncology, University College Hospital, London, UK
About combined androgen blockade:
Combined androgen blockade in prostate cancer refers to the concurrent
administration of an anti-androgen and either an LHRHa (medical castration)
or surgical castration to block both the production of testicular androgens
(testosterone) and residual adrenal androgens from stimulating prostate
cancer cells. The combined action of these treatments works to provide
maximum blockade of androgens (such as testosterone) that stimulate prostate
cancer growth.
About CASODEX:
-- CASODEX (bicalutamide) is an oral non-steroidal anti-androgen for the
treatment of prostate cancer and is the world’s leading anti-
androgen, available in all major European countries and the USA as a
50mg tablet, and in Japan as an 80mg tablet
-- CASODEX (bicalutamide) 50mg was first launched in 1995 as a
combination treatment (with surgical or medical castration) for
advanced prostate cancer and was subsequently launched as a 150mg dose
for extended use either as a monotherapy or adjuvant treatment for
locally advanced disease
-- For further information about CASODEX (bicalutamide) and about
prostate cancer, please visit http://www.casodex.net or
http://www.prostateline.com .
About AstraZeneca:
AstraZeneca is a major international healthcare business engaged in the
research, development, manufacture and marketing of prescription
pharmaceuticals and the supply of healthcare services. It is one of the
world’s leading pharmaceutical companies with leading positions in
gastrointestinal, oncology, cardiovascular, neuroscience and respiratory
products. AstraZeneca is listed in the Dow Jones Sustainability Index
(Global) as well as the FTSE4Good Index.
‘CASODEX’ is a trademark of the AstraZeneca group of companies.
For more information visit:
http://www.astrazenecapressoffice.com
http://www.astrazeneca.com
http://www.prostateline.com
(*) Highest ranking of importance based on a scale of 1 to 5
(1) Physician survey. Conducted from May to June 2006. AstraZeneca
results on file
(2) Klotz L, Schellhammer P, Carroll K. A re-assessment of the role of
combined androgen blockade for advanced prostate cancer. BJU Int. 2004
Jun;93(9):1177-82
(3) Prostate Cancer Triallists’ Collaborative Group. Maximum androgen
blockade in advanced prostate cancer: an overview of the randomised
trials. Lancet 2000; 355: 1491-1498
(4) Crawford ED, Eisenberger MA, McLeod DG et al. A controlled trial of
leuprolide with and without flutamide in prostatic cancer. N Engl J
Med1989; 321: 419-424
(5) Denis LJ, Keupprens F, Smith PH et al. Maximal androgen blockade:
final analysis of EORTC phase III trial 30853. EORTC Genito-Urinary
Tract Cancer Cooperative Group and the EORTC Data Center. Eur Uro
1998; 33: 144-151 [abstract only]
