Drug Therapy

New York--Preliminary results from the first two U.S. patients to undergo surgery to create a somatic-autonomic reflex pathway for micturition suggest the procedure may be an effective, safe treatment for neurogenic bladder secondary to spinal cord injury, report urologists from New York University.

Z?rich Switzerland--Botulinum toxin A (Botox) may be an effective, safe alternative treatment option in patients experiencing overactive bladder refractory to more standard treatments, according to a study performed at the Universit?tsspital Z?rich and Kantonsspital Luzern, Switzerland.

Scottsdale, AZ--Injecting botulinum toxin A (Botox) into the prostate gland shows potential for providing a quick, easy, and safe treatment option for men with lower urinary tract symptoms related to BPH, but two small studies—one from the United States and Chile, and one from Italy—provided equivocal results regarding the efficacy of this investigational approach. While the Italian data showed significant decreases in International Prostate Symptom Score and prostate size with botulinum toxin, U.S. researchers were unable to duplicate these results. Both studies were presented at the AUA annual meeting in San Antonio.

Dendreon Corp. said it plans to submit a biologics license application to the FDA to market APC8015 (Provenge), an investigational immunotherapy for the treatment of prostate cancer.

A combination of samarium SM-153 lexidronam injection (Quadramet) and docetaxel (Taxotere) appears to reduce PSA levels in patients with progressive hormone-refractory prostate cancer, according to a phase II study involving 29 patients.

Washington--Months of intensive lobbying and hard work have paid off for urologists, who now have an outside shot at a net Medicare fee schedule increase for their services, compared with the overall 4.3% reduction for 2006 announced in March.

Mountain View, CA--Apparently avoiding problems with a potentially common drug combination, the investigational premature ejaculation therapy dapoxetine does not interact with phosphodiesterase type-5 inhibitors, according to results of a clinical pharmacokinetics study.

Hamburg, Germany--Serious male cycling enthusiasts might want to consider taking a phosphodiesterase type-5 inhibitor prior to a long ride to prevent pressure-induced hypo-oxygenation of the penis, according to German researchers.

Denver--Studies in recent years have shown a strong correlation between lower urinary tract symptom severity and erectile dysfunction, but there have also been contradictory reports on the effect of BPH medications on sexual health.

The lower infection rate seen in these cases was impressive.

The FDA's Oncology Drug Advisory Committee has not recommended approval of atrasentan (Xinlay), an oral agent for the treatment of metastatic hormone-refractory prostate cancer.

Initial findings from a continuing phase II multicenter study of docetaxel (Taxotere) as adjuvant therapy in radical prostatectomy patients at high risk of recurrence have shown that the drug is well tolerated, with reversible side effects.

The growth of prostate cancer cells can be halted by combining a form of vitamin D with low doses of a nonsteroidal anti-inflammatory drug, according to results of an in vitro study by researchers at the Stanford (CA) University School of Medicine.

Pudendal nerve stimulation, using a pudendal percutaneous implant under neurophysiologic guidance, appears effective in treating neurogenic overactive bladder, Italian researchers reported Thursday.

Amitriptyline (Elavil) is an effective treatment for interstitial cystitis, but it must be dosed carefully, and patients must be closely followed to help manage side effects, researchers reported yesterday.

Two newer-generation antimuscarinic agents &#8212 solifenacin succinate (Vesicare) and tolterodine tartrate extended-release (Detrol LA) &#8212 improve symptoms of overactive bladder, but solifenacin appears to provide superior outcomes, partly because it offers a flexible dosing regimen, researchers say.

Washington--Urologists and other physicians now have some breathing room as they seek to decide whether to participate in the new Competitive Acquisition Program (CAP) established by the Centers for Medicare & Medicaid Services for drugs administered in the office.

Orlando, FL--A small clinical trial presented at the American Society of Clinical Oncology annual meeting has demonstrated the feasibility of a vaccine strategy for the treatment of men with prostate cancer who had completed neoadjuvant chemotherapy or hormone therapy at least 6 months prior to enrollment. The multi-institutional phase II study evaluated the role of vaccination in men with rising PSA after local treatment for prostate cancer using a prime/boost approach with vaccinia virus and fowl pox virus expressing PSA.

Orlando, FL--The addition of the nonsteroidal antiandrogen bicalutamide (Casodex) to a luteinizing hormone-releasing hormone agonist (LHRHa) confers significant benefits over LHRH monotherapy as first-line treatment for advanced prostate cancer, according to a study presented by Japanese researchers at the American Society of Clinical Oncology annual meeting here.

Orlando, FL--Treatment with a novel form of immunotherapy known as APC8015 (Provenge) offers a substantial survival advantage in asymptomatic prostate cancer patients with metastatic disease who have failed to respond to hormone treatment, according to findings from a placebo-controlled phase III trial. At 36 months, 34% of the treated patients were alive versus 11% of those on placebo.

San Antonio—Researchers continue to probe the effects of docetaxel (Taxotere) on prostate cancer in efforts to devise the most efficacious application of the compound. Combining the agent with thalidomide (Thalomid) appears to enhance survival in androgen-independent disease, according to a phase II National Cancer Institute study whose initial data appeared earlier this year.

San Antonio--The foundation for a wider application of docetaxel (Taxotere) in prostate cancer is being laid, but it is far from complete. Two major studies appearing last year allowed the drug to replace mitoxantrone (Novantrone) as a first-line treatment in hormone-resistant metastatic prostate cancer. Data from a continuing phase II study of the agent as adjuvant therapy in radical prostatectomy patients at high risk of recurrence were presented here at the AUA annual meeting. Initial findings have shown that the drug is well tolerated, with reversible side effects.

Results of a U.S. phase II trial investigating the safety, tolerability, and efficacy of the nonselective muscarinic antagonist fesoterodine fumarate in patients with detrusor overactivity offer hope for the 10% of men and women over age 40 years who have the syndrome, researchers say.

No single study on the topic of sexual dysfunction leapt from the podium as a breakthrough at this year's AUA annual meeting, but a number of studies offered valuable observations about various aspects of sexual function/dysfunction. Among these were studies showing that the degree of personal involvement in restoring sexual function after radical prostatectomy correlates with the degree of success, said John Mulcahy, MD, PhD, professor of urology, Indiana University Medical Center, Indianapolis. Also, research showed that erectile dysfunction can be associated with metabolic disorders and heart disease, and when prescriptions with level 1 interactions overlap, they are often for sildenafil citrate (Viagra) and nitrates.

San Jose, CA--Laserscope has launched a redesigned version of its GreenLight laser system for photoselective vaporization of the prostate (PVP), indicated for the treatment of BPH. The system features new fiber optic delivery device enhancements that permit greater flexibility and control during treatment, increased system up-time, faster setup time, and real-time response to fiber manipulation. This version of the system is available new and as a system upgrade.

San Antonio--Five years after radical prostatectomy, fewer than half of the men with erectile dysfunction who responded initially to sildenafil citrate (Viagra) continued to respond to the drug, which works best in patients who have had bilateral nerve-sparing surgery, according to a report presented at the AUA annual meeting here.

San Antonio--Almost half of all patients with erectile dysfunction following radical prostatectomy decide against any form of treatment for ED, Italian investigators reported at the AUA annual meeting here.

San Antonio--The United States and United Kingdom are two nations united by a common language and also an apparent proclivity for using complementary therapies to treat prostate cancer. A study presented at the AUA annual meeting found that one in four prostate cancer patients in the United Kingdom used complementary medicines. A similar report, published 2 years ago in the Journal of Clinical Oncology (2003; 21:2199-210), found that 23.5% of U.S. patients used complementary medicine.

San Antonio--A study relating prostate size to tumor grade presented here at the AUA annual meeting appears to dispel the concern that finasteride (Proscar) as a prophylaxis for prostate cancer might increase the incidence of higher-grade tumors.

San Antonio--A number of new techniques for management of urinary incontinence and other female urologic problems are affording promising results, according to studies presented at the AUA annual meeting. However, urologists wondering about integrating those approaches into their clinical practices need to be very careful in considering the data, paying special attention to issues of durability and comparisons with existing treatment approaches, said Shlomo Raz, MD, professor of urology at UCLA School of Medicine.