Dr. Dreicer on Prostate Cancer Drug Development Challenges

Robert Dreicer, MD, MS, chairman of the Department of Solid Tumor Oncology at the Taussig Cancer Institute and professor of Medicine at the Cleveland Clinic in Ohio, discusses challenges facing the development of new lyase inhibitors and androgen receptor (AR) antagonists as treatments for men with prostate cancer.

Researchers exploring the clinical development of new lyase inhibitors and AR antagonists, such as orteronel (TAK-700) and ARN-509, are challenged by a need to differentiate these agents from abiraterone acetate and enzalutamide. To address these challenges, Dreicer believes that newer lyase inhibitors that have the potential to be utilized without the coadministration of steroids should be developed in this fashion. This aspect should be explored further, particularly since it remains unclear whether these newer agents will be more clinically active than those already approved.

Clinical trials comparing existing AR antagonists and lyase inhibitors to newer agents are likely not to occur, Dreicer believes, which adds further difficulty to the development of these agents. As a result, Dreicer believes these newer agents have the most potential in earlier stages of nonmetastatic castration-resistant prostate cancer and in patients with localized high-risk prostate cancer, rather than in direct competition with existing agents.