Updates for January 2014

Jan 25, 2014. In Biochemical PSA Recurrence we added: Itraconazole. A 2013 John Hopkins study found that among 29 men with of metastatic castration-resistant prostate cancer taking 600 mg/day of the drug itraconazole (which is currently approved in the US as an antifungal and is also known as Onmel® or Sporanox®) resulted in no PSA progression in 14 of 29 high dose subjects at 24 weeks. The high dosage seems essential as among 17 men in a low dose arm (200 mg/day) it was found to be ineffective and that part of the study terminated early. This and previous test tube and animal studies (see references 11-16 in paper) found that the mechanism of action is to inhibit angiogenesis and Hedgehog signaling. The researchers concluded that the high dose regimen has "has modest antitumor activity". Side effects included fatigue, nausea, anorexia, rash, and a syndrome of hypokalemia, hypertension, and edema. Additional side effects are listed here. There are a number of drugs which should not be taken with Itraconazole. See Wikipedia. The abstract and full paper are available here: [PMID: 23340005] [Full paper].