Analyze the Predictive Value of Gene TMPRSS2-ETS in Response to Enzalutamide in Patients With Prostate Cancer
Status:
Completed
Trial end date:
2019-07-22
Target enrollment:
Participant gender:
Summary
Prostate cancer is the most common non-skin tumor diagnosed in men and the second leading
cause of cancer death in men in Western countries.
Between 10-20% of patients are diagnosed at metastatic stage and about half of those
diagnosed in early stages will develop metastases.
After the clinical benefit of mitoxantrone and the improved survival of 2-3 months provided
by docetaxel in first line, the second search is driven to look for effective second lines
treatments. In recent years, there are new drugs for the treatment of prostate cancer,
revolutionizing the therapeutic sequence and survival.
Thus, androgen deprivation therapy, treatment of choice, induces an improvement of symptoms
in approximately 70-80% of patients, but it is limited by the development of mechanisms of
resistance to androgen deficiency. Docetaxel was the first chemotherapy drug to increase
survival in patients with metastatic prostate cancer. The second cytotoxic drug approved in
the second line treatment of metastatic CRPC has been cabazitaxel.
Enzalutamide improves survival in patients with metastatic CRPC who had progressed to
chemotherapy and also in patients who had not received chemotherapy.
To date, there are no biomarkers available that allow us to identify which patients from a
clinical or molecular view are those that will be able to benefit from the treatment options
currently available. The presence of the TMPRSS2-ETS rearrangement has been shown to
correlate with efficacy in clinical practice abiraterone.
There is scientific and preclinical background that makes one suspect that the molecular
alteration may influence the same way enzalutamide antiandrogen activity, but it has not been
determined to date.
The objective of this study is to determine whether the efficacy and safety of enzalutamide,
when administered to patients with castration resistant prostate cancer prior to
administration of docetaxel is influenced by the presence or absence of the fusion gene
TMPRSS2- ETS.