Provenge

A Mental Countdown

Four weeks went real fast.

Monday is my next appointment with Dr. V.

Where does the time go?

I approach this meeting with absolutely no expectation or preconceived idea about what the results
will show. I have been through the little dance too many times over the past 57 months to worry or even attempt to guess where this is going.

My leg is returning to normal, though there is still occasional, very mild pain. Usually if I sit too long. We will discuss with Dr. V for sure.

In the past week there have been three pieces of news related to prostate cancer that are of interest.

First, Dendreon Pharmaceuticals announced that they have submitted their application to the FDA for the drug Provenge. This has been a six year journey for them and somewhat good news for the group I fall into; late stage, hormone refractory. Provenge has been shown to add an average of four months of life. While this doesn’t sound like much, it is rather significant.

A new drug from Epeius Biotechnologies called REXIN-G made quite a splash this week. In early stage trials it is showing very promising results. I am not one to get too excited, it’s early, and the trials are limited, but it adds a little much needed HOPE.

Finally, the American Urological Association came out with a position that clarifies the need for continued early screening. I hope this goes a long way to help counteract statements made last month by the head of the American Cancer Society. As a PCa friend said via Twitter yesterday; screening should not be the controversy, the controversy lies in the decisions made around treatments. Particularly for men with early stage and low grade PCa.

And so I close with this, Hope lives on in me, always. This disease may take my life, but it will not kill me. What I mean by that, and pardon me for being repetitive, is that in the face of this adversity I push on full speed. With the strength provided by my wife, my son, my family, my friends and complete strangers, I march on into this daily battle with my head held high!

Up, up and ?

We went to the KU Cancer Center this morning for my monthly visit with Dr. V and to receive my monthly Lupron shot. We left with one of those good news/bad news stories.


Good news is they took all the correct samples etc. and we were in and out in just over two hours! No missing vials, missed tests or long waits for the pharmacy. It was efficiency at it’s finest!

On the other hand, my PSA was up, way up. It now stands at 97.04 up from 66.14 last month.
While we did agree to pay less attention to my PSA when we left MD Anderson in April, this climb has me a bit concerned. This is my highest level since September 2006.I did leave with two new prescriptions for Ketoconozale and Hydrocortizone (HDK). This combination is what I took in 2006 when my initial treatment stopped working. It worked for 16 months, then I tried Nilandron, then I did chemo. Going back to Keto + HDK is somewhat of a risk. There is a chance that it might not work at all. We decided to give it one more try before moving on to something more serious and more toxic. We can try DES (very low amounts of estrogen) but want to keep that in reserve and may end up trying that next. Until some of the newer drugs (Provenge and Abiraterone) are either approved or open new trials, my next choice is another round of chemo in combination with some sort of clinical trial.I knew my PSA was going to be higher, I just did not expect it to be such a dramatic increase.

Last month when we met with Dr. V we discussed the option of starting Keto again, as we were aware my PSA level was steadily trending upwards. I’m not sure about all this yet. Mary and I had lunch and I came back to work. My head is swimming right now with many thoughts.

~~~~~~~~~~~~~~~~~

On another note, the World Disc Golf Championships are being held in Kansas City next week. Nearly 1,000 disc golfers from around the world will be competing in various age groups and divisions. I signed up to play in the ‘Advanced Masters” division. This is for non-professional men over the age of 40. We play one round on Tuesday, two on Wednesday and Thursday and one more on Friday (the leaders play again Saturday).

Several of the guys I play with (who are better than me!) are in the same division and over all about seven of use that play on Saturday’s have entered in various divisions. Here is the website: http://kcworlds.com/

Starting on Tuesday the 28th you can see how I’m doing here: http://pdga.org/tournament-results?TournID=8105 Scroll down to “Advanced Masters” and look for my name, I signed up late so I’m not showing up as registered yet.

I really have no expectations but have set a few goals for myself; I want to post no score higher than the 60’s and finish in the 75th percentile or my division. Us local guys should have a slight advantage playing these courses all the time, but we’ll see if that helps at all! Overall, I just want to have fun, meet some new people and play respectable over the four days.

Spring and a few other things

This might finally be the week when we put winter behind us. I say that with some trepidation, not wanting to jinx things. I planted spinach about a month ago and it is finally making some real progress, however harvest and a fresh salad from the bounty are weeks away.

We played in a rain soaked disc golf tournament on Saturday and I hope to get out a few times this week and weekend. Additionally, plans are well under way for our second annual FLHW disc golf tournament on May 9th. Details are at http://www.flhw.org/2009discgolf.htm

Since returning from Houston, I’ve really been trying to take the doctor’s advice to just get on with it. We have been really wanting to get back to Florida and may try to plan a trip for when school gets out. I could use some sand between my toes!

My next appointment with Dr. V is next Monday and for once I am not real concerned. Well maybe just a little. There is potentially some good news on the horizon for those of us with advanced prostate cancer.

I’ve written about this new drug, Provenge, a number of times over the years. My first post on Provenge was on October 24, 2006. Next week the company is scheduled to announce the results of their Phase III trial and rumor has it, the news is good. What that means is, in the best case scenario, the drug may be available in the first quarter of 2010. Available and approved or paid for by insurance are two completely different things as well. It is still good news and apparently there may be more regarding other treatments in the months ahead. Again, nothing curative, simply drugs or treatments that may extend the life of those with advanced PCa.

Hope, in the future

It has been quite sometime since I provided any updates on PC research, etc.
Frankly, there hasn’t been anything positive to report, as sad as that is.

Yesterday was news that a trial for GVAX was officially cancelled. Another promising drug,
Provenge looks like it is still 12-18 months aways from possible FDA approval.

Not to be a downer, but the outlook for us guys with the advanced disease is not all that promising. That is not to say that I, and guys in my situation are out of options. I’m just saying there are not many promising things on the horizon or many options besides hormone therapy and chemotherapy.

There are a few treatments that are currently being researched, one is Abiraterone. See the press release from Cougar Biotechnology below.
The current clinical trials exclude those that have previously taken ketoconizal, so for now, I’m on the outside looking in. However, since I responded so favorably to the keto, Mary and I are hopeful that this may be an effective treatment for me in the future. It offers an option and it offers hope!

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Positive Phase II Data on Cougar Biotechnology’s CB7630 Presented at Prostate Cancer Foundation Scientific Retreat

Interim Phase II Results Support Efficacy of CB7630 (Abiraterone Acetate) in Advanced Prostate Cancer Patients

LOS ANGELES, Oct 17, 2008 (BUSINESS WIRE) — Cougar Biotechnology, Inc. (CGRB:


cougar biotechnology inc com


CGRB 27.01, -0.18, -0.7%)

today announced that results from an ongoing Phase II clinical trial of Cougar’s investigational drug CB7630 (abiraterone acetate) were presented today at the Prostate Cancer Foundation Scientific Retreat. The Prostate Cancer Foundation Scientific Retreat is currently taking place in Lake Tahoe, Nevada.

The clinical trial of CB7630 was conducted at the University of Texas M.D. Anderson Cancer Center in order to investigate associations between serum and microenvironment (bone marrow) androgen concentrations and response to CB7630. In the trial, CB7630 in combination with prednisone was administered orally, once daily, to patients with castration resistant prostate cancer (CRPC), who had progressive disease despite treatment with LHRH analogues and multiple other therapies. All of the 44 patients who were enrolled in the trial had radiological evidence of metastatic disease with bone metastases. Thirty-eight patients (86%) had at least 10 metastatic bone lesions, 7 patients (16%) had metastases in the liver and 14 patients (32%) had lymph node metastases. Twenty-five (57%) of the 44 patients had received prior treatment with ketoconazole and/or diethylstilbesterol and 38 patients (86%) had received prior treatment with chemotherapy, with 27 patients (61%) having received two or more prior chemotherapy regimens before entering the trial.
In her poster presentation entitled, “Identification of an androgen withdrawal responsive phenotype among patients with castrate resistant prostate cancer (CRPC) treated with abiraterone acetate, a selective CYP17 inhibitor (COU-AA-BMA),” Dr. Eleni Efstathiou from the University of Texas MD Anderson Cancer Center presented data on the 41 evaluable patients treated in the trial. Of the 41 evaluable patients, 21 patients (51%) experienced a confirmed decline in prostate specific antigen (PSA) levels of greater than 50% with a median duration of 6+ months. In addition, 5 patients (12%) experienced PSA declines of greater than 90%. Of the 41 evaluable patients, 24 (59%) experienced an improvement in performance status.
Of the 16 evaluable patients with bone metastases, after 6 months of treatment 4 patients (25%) showed an improvement in their bone scan and 11 patients (69%) showed a stable bone scan. Also, 5 of 5 patients with lymph node metastases showed stable disease after 6 months of treatment with CB7630 and 1 of 2 patients with liver metastases demonstrated a partial radiological response (as measured by the RECIST criteria).

Both serum and bone marrow testosterone levels were measured before and after treatment with CB7630. A decline in both serum and bone marrow testosterone levels to below detectable levels (<10ng/ml) was seen in all patients in the trial. Also, patients with depleted baseline bone marrow testosterone levels (<10ng/ml) appeared to progress earlier when treated with CB7630 (p=0.05) compared to patients with measurable baseline bone marrow testosterone levels. Further examination of the bone marrow biopsies of patients treated with CB7630 in this study revealed both overexpression of androgen receptor and CYP17 overexpression.

Alan H. Auerbach, Chief Executive Officer and President of Cougar Biotechnology, said, “The data from our COU-AA-BMA trial of CB7630 presented at the Prostate Cancer Foundation Scientific Retreat continues to support the potential role of the drug in the treatment of CRPC. We continue to be pleased with the strong evidence of antitumor activity in patients with chemotherapy refractory disease, which represents a significant unmet medical need in prostate cancer.”

Arturo Molina, M.D., M.S., ACP, Cougar’s Chief Medical Officer and Executive Vice President of Clinical Research and Development, added, “We are pleased to present the results of this Phase II study and we are intrigued by its findings. The identification of CYP17 expression in CRPC tumor metastases and observation that both serum and bone marrow testosterone levels decline after CB7630 therapy suggests that treatment with CB7630 results in the inhibition of adrenal and intra-tumoral androgen synthesis.”

About Cougar Biotechnology
Cougar Biotechnology, Inc. is a Los Angeles-based biotechnology company established to in-license and develop clinical stage drugs, with a specific focus on the field of oncology. Cougar’s oncology portfolio includes CB7630, a targeted inhibitor of the 17-alpha hydroxylase/c17,20 lyase enzyme, which is currently being studied in a Phase III clinical trial in prostate cancer; CB3304, an inhibitor of microtubule dynamics, which is currently in a Phase I trial in multiple myeloma; and CB1089, an analog of vitamin D, which has been clinically tested in a number of solid tumor types.

Further information about Cougar Biotechnology can be found at www.cougarbiotechnology.com.

This press release contains forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. These statements are often, but not always, made through the use of words or phrases such as “anticipates,” “expects,” “plans,” “believes,” “intends,” and similar words or phrases. These forward-looking statements include, without limitation, statements related to the benefits to be derived from Cougar’s drug development programs, including the potential advantages of CB7630 and its potential for use in the treatment of CRPC and in second-line hormone and chemotherapy treatment settings. Such statements involve risks and uncertainties that could cause Cougar’s actual results to differ materially from the anticipated results and expectations expressed in these forward-looking statements. These statements are only predictions based on current information and expectations and involve a number of risks and uncertainties. Actual events or results may differ materially from those projected in any of such statements due to various factors, including the risks and uncertainties inherent in clinical trials, and drug development and commercialization, including the uncertainty of whether results of prior clinical trials of CB7630 will be predictive of results of later stage clinical trials, including Cougar’s ongoing Phase III clinical trial, COU-AA-301. For a discussion of these and other factors, please refer to Cougar’s annual report on Form 10-KSB for the year ended December 31, 2007, as well as other subsequent filings with the Securities and Exchange Commission. You are cautioned not to place undue reliance on these forward-looking statements, which speak only as of the date hereof. This caution is made under the safe harbor provisions of the Private Securities Litigation Reform Act of 1995. All forward-looking statements are qualified in their entirety by this cautionary statement and Cougar undertakes no obligation to revise or update this press release to reflect events or circumstances after the date hereof.

SOURCE: Cougar Biotechnology, Inc.
Cougar Biotechnology, Inc.
+1-310-943-8040
Alan H. Auerbach, Chief Executive Officer and President
ahauerbach@cougarbiotechnology.com
Mariann Ohanesian, Director of Investor Relations
mohanesian@cougarbiotechnology.com
or
Russo Partners, LLC
David Schull, +1-212-845-4271
David.schull@russopartnersllc.com
Andreas Marathovouniotis, +1-212-845-4235
Andreas.marathis@russopartnersllc.com

Copyright Business Wire 2008