1. The future of our patients already treated with first line chemotherapy
First of all, I would like to take this opportunity to thank the Mediterranean Multidisciplinary Oncology Forum for inviting me here to speak before you today. I am excited about this new organization and look forward to further cooperation and exploration among researchers in the Mediterranean area.
Today I am going to talk about…
Jose R. Germà Lluch MD PhD
Institut Català of Oncology

2. 1970 1980 1990 2000 Early reviews reported OR in 6.5% of 3184 patients
Colon Cancer
QMT. Metastatic & Adjuvant
Breast Cancer
QMT. Metastatic
Lung Cancer
QMT. Metastatic
Lung Cancer
QMT. Adjuvant
Breast Cancer
QMT. Adjuvant
1970
1980
1990
2000
Early reviews reported OR in 6.5% of 3184 patients
Review from 26 trials published between :
- OR 8.7% (95% CI %).
- OR rate >10%: vinblastine, trimetrexate, mitoguazone &
estramustine.
Yagoda A. Cancer 71: , 1993.
Mitoxantrone/Prednisone as the palliative standard of care.
Tannock IF. J Clin Oncol 14: , 1996.
Kantoff PW. J Clin Oncol 17: , 1999.
Docetaxel as the standard of care in HRPC leading to superior OS and improved RR in terms of pain, serum PSA levels and QOL.
Tannock IF. N Engl J Med 351: , 2004.
Petrylak DP. N Engl J Med 351: , 2004.

3. TAX 327 SWOG 9916 increased rates of AEs.
1) It is secure.
1) Improvement in Sv at the cost of an
2) Significant Improvement of:
increased rates of AEs.
- Survival (18.9 vs 16.5 months).
2) Significant Improvement of:
24% risk of death reduction (p=0.009).
- Survival (17.5 vs 15.6 months).
- PSA response (45% vs 32%, p=0.0005).
20% risk of death reduction (p=0.02).
- Pain improvement (35% vs 22%, p=0.01).
- PSA response (50% vs 27%, p<0.001).
- QOL (22% vs 13%, p=0.009).

4. 116 Patients Institut Català d’Oncologia l’Hospitalet
Median (IC 95%; – )
Change hydroxyl for methoxy

5. Institut Català d’Oncologia l’Hospitalet
88 Patients Received Docetaxel in a 3 weekly Schedule:
Mediana (IC 95%; – )
Change hydroxyl for methoxy

6. Bone metastases – 63% Paliative Radiation 60% Bifosfonates
Change hydroxyl for methoxy
Median age – 67 yo (49 – 80)
Bone metastases – 63% Paliative Radiation
60% Bifosfonates
Analgesic use – 0: 35%
1: 59.8%
2: 14.5%
3: 25.8%
Median OS (IC 95%; – )

7. Change hydroxyl for methoxy
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9. CABAZITAXEL
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11. After 12-24 moths these b… become hormone independent
6 months from a aisymtomatic to become symtomatic.
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12. After 12-24 moths these b… become hormone independent
6 months from a aisymtomatic to become symtomatic.
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13. After 12-24 moths these b… become hormone independent
6 months from a aisymtomatic to become symtomatic.
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14. These
After moths these b… become hormone independent
6 months from a aisymtomatic to become symtomatic.

15. These
After moths these b… become hormone independent
6 months from a aisymtomatic to become symtomatic.

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19. Institut Català d’Oncologia l’Hospitalet
88 Patients Received Docetaxel in a 3 weekly Schedule:
Mediana (IC 95%; – )
Second-line chemotherapy
50% Ciclofosfamide
22% Mitoxantrone
11% Docetaxel (3 wk)
11% Docetaxel (weekly)
6% Abiraterone
Change hydroxyl for methoxy

20. Trial (Agent Approved) Year Disease State Comparator HR P value
TAX327
(Docetaxel)
2004
Chemo-naïve CRPC
Mitoxantrone
Prednisone
0.76 ( )
0.009
SWOG 9916
Mitoxantrone Prednisone
0.80 ( )
0.02
TROPIC (Cabezitaxel)
2010
Post-Docetaxel
CRPC
0.70 ( )
<0.0001
Docetaxel
2.4 m
Cabecitaxel
2.4 m
ORGAN CONFINED
LOCALLY ADVANCED
RISING PSA HORMONE NAIVE
RISING PSA ANDROGEN INDEPENDENT
CLINICAL METASTASIS AI ASYMPTOMATIC
CLINICAL METASTASIS AI SYMPTOMATIC
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21. Trial (Agent Approved) Year Disease State Comparator HR P value
IMPACT
(Provenge vaccine)
2010
Chemo-naïve
CRPC
Placebo
0.775 ( )
0.032
TAX327
(Docetaxel)
2004
Chemo-naïve CRPC
Mitoxantrone
Prednisone
0.76 ( )
0.009
TROPIC (Cabezitaxel)
Post-Docetaxel
0.70 ( )
<0.0001
COU-AA-301 (Abiraterone)
0.64 ( )
Sipuleucel-T
4.1 m
Docetaxel
2.4 m
Cabezitaxel
2.4 m
Abiraterone
3.9 m
ORGAN CONFINED
LOCALLY ADVANCED
RISING PSA HORMONE NAIVE
RISING PSA ANDROGEN INDEPENDENT
CLINICAL METASTASIS AI ASYMPTOMATIC
CLINICAL METASTASIS AI SYMPTOMATIC
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22. MDV3100 MDV3100 PROSTVAC IPILIMUMAB Sipuleucel-T 4.1 m Docetaxel 2.4 m
Cabezitaxel
2.4 m
Abiraterone
3.9 m
COMBINATIONS
DENOSUMAB
ORGAN CONFINED
LOCALLY ADVANCED
RISING PSA HORMONE NAIVE
RISING PSA ANDROGEN INDEPENDENT
CLINICAL METASTASIS AI ASYMPTOMATIC
CLINICAL METASTASIS AI SYMPTOMATIC
Abiraterone
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23. Thank you for your attention.
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Hank you for your attention