ROCKVILLE, Md--To the surprise of many, the FDA Oncology Drugs Advisory Committee recommended that Taxotere (docetaxel, Rhône-Poulenc Rorer) not be approved for marketing at this time. The company was seeking approval of the drug for use in locally advanced or metastatic breast cancer when previous therapy with an anthracycline has failed, and in locally advanced or metastatic non-small-cell lung cancer after failure of platinum-based chemotherapy.
Taxotere was characterized by the committee as being very efficacious , but having serious problems with toxicity. In addition, committee members felt that it was difficult to judge the net benefit of Taxotere based only on phase II trials, and urged that phase III studies be performed.
Ethyol Rejected
Ethyol (amifostine, U.S. Bioscience) also was not recommended for approval. The drug is a cytoprotective agent against acute and cumulative hematologic and renal toxicities associated with alkylating agents such as cyclophosphamide(Drug information on cyclophosphamide) (Cytoxan, Neosar) and platinum agents such as cisplatin(Drug information on cisplatin) (Platinol), and the company was seeking approval for use in ovarian cancer patients receiving those drugs. The committee said that Ethyol produced very little improvement in survival rates and caused significant toxicity (nausea, vomiting, and hypotension).
The committee recommended two drugs for approval: Zinecard (dexrazoxane, Pharmacia) to prevent and/or reduce the incidence and severity of cardiomyopathy associated with use of doxorubicin(Drug information on doxorubicin), and Vesanoid (tretinoin, all-trans-retinoic acid, Hoffman-LaRoche) for the treatment of patients with acute promyelocytic leukemia.
A detailed discussion of the committee's deliberations surrounding these four drugs will appear in next month's issue.
A 70-year-old man with a history of localized prostate cancer treated with whole-pelvis radiation therapy with a boost to the prostate, in conjunction with androgen deprivation therapy 7 years prior, presented with lower back pain. A bone scan revealed an area of activity in the sacrum. What is the most likely diagnosis?
