Drug Therapy

Treatment with the investigational agent toremifene citrate (Acapodene) decreased the incidence of prostate cancer by 1 year in patients with high-grade prostatic intraepithelial neoplasia, according to a study published recently in the Journal of Urology (2006; 176:965-71).

Patients with BPH who were treated with the investigational drug NX-1207 showed a total pooled mean improvement of 9.35 points in the primary outcome endpoint of AUA Symptom Score values at 3 months, researchers from Nymox Pharmaceutical Corp. reported.

Phase III of the double-blind, randomized Satraplatin and Prednisone Against Refractory Cancer (SPARC) trial has shown a 40% reduction in the risk of disease progression in patients who received satraplatin plus prednisone.

Minneapolis-For men suffering from the most common sexual dysfunction, premature ejaculation, an investigational drug therapy may offer improved control over ejaculation and sexual satisfaction with a relatively low incidence of side effects.

San Antonio-The Prostate Cancer Prevention Trial (PCPT) showed conclusively that finasteride (Proscar), a 5-alpha-reductase inhibitor indicated for the treatment of BPH, reduced the incidence of prostate cancer by nearly 25%. Continuing analysis of data from that trial now show the drug also enhances detection of prostate cancer by significantly improving the specificity of the PSA assay, according to a study published recently in the Journal of the National Cancer Institute (2006: 98:1128-33).

Cleveland-Patients undergoing laparoscopic radical prostatectomy can expect continuing improvement in urinary and sexual functions for up to 2 years after the procedure, according to a single-institution study from the Johns Hopkins Medical Institutions in Baltimore, presented here at the 2006 World Congress of Endourology.

Treatment with a calcium-channel blocker or alpha-blocker can greatly improve a patient's likelihood of passing urinary stones, which may help these patients avoid surgery, according to a meta-analysis conducted at the University of Michigan Health System, Ann Arbor.

Atlanta-Neoadjuvant chemotherapy using a three-drug combination has demonstrated activity in locally advanced transitional cell carcinoma (TCC) of the bladder, but it also possesses considerable toxicity. That was the conclusion reported in a poster by University of Michigan researchers at the American Society of Clinical Oncology annual meeting.

Atlanta-Adjunctive treatment with the alpha-blocker tamsulosin (Flomax) improves stone clearance and significantly reduces ureteral colic following ureteroscopic laser lithotripsy, researchers reported at the AUA annual meeting.

Several studies presented at the 2006 AUA annual meeting provided evidence of a relationship between erectile dysfunction and lower urinary tract symptoms, with some data showing that treatment of LUTS will improve ED and vice versa. Treating multiple conditions at once means that patients may be able to receive better overall care, but physicians must avoid simply treating symptoms and take a more global approach to patient care, according to Steven A. Kaplan, MD. In this Urology Times interview, Dr. Kaplan, professor of urology and chief of the Institute of Bladder and Prostate Health at Weill Cornell Medical College, Cornell University, New York, discusses current findings on the association between ED and LUTS and their implications for patient management. He was interviewed by UT Editorial Consultant Philip M. Hanno, MD, MPH, professor of urology at the University of Pennsylvania, Philadelphia.

Linthicum, MD-AUA has partnered with two leading ophthalmology groups to raise awareness that individuals with past or present use of an alpha-1 blocker may develop a condition known as intraoperative floppy iris syndrome (IFIS) while undergoing cataract surgery and should inform their ophthalmologist about such medication use so that appropriate surgical techniques can be used.

Location may be everything when it comes to the pain associated with prostate biopsy.

Nonsteroidal anti-inflammatory drugs such as aspirin and ibuprofen may prevent or delay BPH, according to a study conducted by researchers at the Mayo Clinic, Rochester, MN.

UCLA has launched a new Integrative Urology Program, which combines Western medicine, traditional Chinese medicine, and the latest nutritional advice.

The FDA has approved several abbreviated new drug applications for generic versions of ciprofloxacin injection for bacterial infections, including urinary tract infections.

A daily glass of orange juice may help prevent the recurrence of kidney stones better than other citrus fruit juices such as lemonade, according to a small study from the University of Texas Southwesten Medical Center, Dallas.

GlaxoSmithKline has initiated REDEEM, a multicenter, North American clinical trial designed to determine whether the 5-alpha-reductase inhibitor dutasteride (Avodart) can delay or prevent prostate surgery or radiation, shrink prostate cancer tumors, and lessen severity of tumors in men with low-grade prostate cancer.

AUA, the American Society of Cataract and Refractive Surgery, and the American Academy of Ophthalmology have advised patients taking alpha-blockers for BPH treatment to inform their eye surgeon about the drugs before undergoing eye surgery.

Atlanta-A trial of drug regimens in hormone-refractory prostate cancer came up with only modest results, but it did take an important first step: It is one of the first prospective trials conducted in taxane-refractory disease.

Spencer, IN-Cook Urological's 1.7F NCompass Nitinol Stone Extractor features a tipless 16-wire dual basket design that securely traps and extracts kidney stones and stone fragments as small as 1.5 mm without impeding irrigation or visibility during the procedure. Made from the shape-memory alloy of titanium and nickel, nitinol, the extractor's design minimizes tissue trauma and provides stability and ease of movement during procedures, according to Cook.

Atlanta-Two recent studies have provided promising outcomes data on sorafenib tosylate (Nexavar), both as a second-line therapy and potentially as first-line treatment in patients with advanced renal cell carcinoma, researchers reported at the American Society of Clinical Oncology annual meeting here.

Atlanta-Sorafenib tosylate (Nexavar), a newer oral multi-kinase inhibitor that targets tumor growth and vascularization, was generally well tolerated by patients with metastatic clear-cell renal cell carcinoma in a randomized phase II trial that compared the efficacy and tolerability of the drug with that of interferon in first-line therapy. Study results were presented by Bernard Escudier, MD, head of the immunotherapy and innovative therapy unit at Institut Gustave Roussy Villejuif, Cedex, France, at the American Society of Clinical Oncology annual meeting here.

Atlanta-Contrary to earlier data from a single-arm study, the addition of erlotinib (Tarceva) to the monoclonal antibody bevacizumab (Avastin) does not significantly delay disease progression in patients with metastatic renal cell carcinoma, according to data presented at the American Society of Clinical Oncology annual meeting. The new findings suggest that bevacizumab is responsible for increasing progression-free survival in this patient population.

Atlanta-How many significant clinical advances began like this?

Atlanta-Sometimes studies are more notable for the questions they raise than for the ones they answer. Kevin T. McVary, MD, professor of urology at Northwestern University Feinberg School of Medicine, Chicago, presented a study at the AUA annual meeting showing that the phosphodiesterase type-5 inhibitor sildenafil citrate (Viagra) improves both erectile function and lower urinary tract symptoms, but has no apparent effect on flow rates.

Atlanta-Urologists can add one more alternative, plant-based medication to the list of intriguing possibilities for treating urologic disease. This one is a rye-pollen extract called Cernilton that showed promising results in chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) in a preliminary, placebo-controlled study from Germany.

Atlanta-Based on the landmark TAX-327 study, which showed a survival benefit of treatment every 3 weeks with docetaxel (Taxotere)/prednisone over mitoxantrone hydrochloride/prednisone, the every-3-weeks docetaxel regimen has now become a standard of care for men with metastatic hormone-refractory prostate cancer.

Atlanta-Initial results with neoadjuvant celecoxib (Celebrex) strongly suggest that this may be a promising agent in the management of patients with early localized prostate cancer, British researchers reported at the American Society of Clinical Oncology annual meeting.

Atlanta-A trial of drug regimens in hormone-refractory prostate cancer came up with only modest results, but it did take an important first step: It is one of the first prospective trials conducted in taxane-refractory disease.

Atlanta-Neoadjuvant docetaxel added to androgen suppression therapy and radiation therapy appears to be safe and active in patients with high-risk localized prostate cancer, according to findings of a new phase II study from Canada reported here at the American Society of Clinical Oncology annual meeting.