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Antitumour activity of MDV3100 in castration-resistant prostate cancer: a phase 1–2 study

Open access
Scher, Howard I, Beer, Tomasz M, Higano, Celestia S, Anand, Aseem, Taplin, Mary-Ellen, Efstathiou, Eleni, Rathkopf, Dana, Shelkey, Julia, Yu, Evan Y, Alumkal, Joshi, Hung, David, Hirmand, Mohammad, Seely, Lynn, Morris, Michael J, Danila, Daniel C, Humm, John, Larson, Steve, Fleisher, Martin, Sawyers, Charles L·2010·The Lancet

Abstract

Background MDV3100 is a rationally-designed androgen receptor antagonist that blocks androgen receptor (AR) binding, nuclear translocation, and co-activator recruitment more effectively than the androgen receptor antagonists currently in use. MDV3100 is also unique in that it prevents DNA binding, induces apoptosis, and has no agonist activity when AR is overexpressed. Because growth of castration-resistant prostate cancer (CRPC) appears to depend upon continued androgen receptor signaling, we hypothesized that MDV3100 could be effective therapy for men with CRPC. Antitumor activity and safety were assessed in a phase 1-2 trial. Methods Eligible patients with progressive metastatic CRPC were enrolled in cohorts of 3-6 patients. Once the safety of a dose was established, cohorts were expanded to include at least 12 chemotherapy-naïve and 12 post-chemotherapy treated patients. Findings 140 patients were treated with doses ranging from 30 to 600 mg daily. Positron emission tomography (PET) imaging to assess androgen receptor blockade showed decreased 18-fluorodihydrotestosterone binding at dosages of 60 mg/day and above. Antitumor effects were observed at all dosages including declines in serum PSA of 50% or more in 56% of patients, responses in soft tissue, stabilized bone disease, and conversion from unfavourable to favourable circulating tumour cell counts. The median time to progression was 47 weeks for radiological progression. The maximal tolerated dose for sustained treatment (>28 days) was 240 mg and the most common adverse event was dose-dependent fatigue, which generally resolved following dose reduction. Interpretation Encouraging antitumor activity on all outcomes assessed was observed for MDV3100 in both chemotherapy-naïve and post-chemotherapy patients with CRPC, establishing that patients with CRPC are not uniformly hormone-refractory. A phase 3 trial in patients with progressive disease after docetaxel treatment is underway.

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Metadata

Authors
Scher, H. I., Beer, T. M., Higano, C. S., Anand, A., Taplin, M.-E., Efstathiou, E., Rathkopf, D., Shelkey, J., Yu, E. Y., Alumkal, J., Hung, D., Hirmand, M., Seely, L., Morris, M. J., Danila, D. C., Humm, J., Larson, S., Fleisher, M., & Sawyers, C. L.
Venue
The Lancet
Publisher
Elsevier BV
Published
2010-04
Volume
375
Issue
9724
Pages
1437-1446
ISSN
  • 0099-5355 (ISSN-L)
  • 0140-6736
OpenAlex
W2165782799
Cited by
1,063
References
9
FWCI
113.14
Type
journal article
Language
en
Open access
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CoChat. (2026). Citation check: Antitumour activity of MDV3100 in castration-resistant prostate cancer: a phase 1–2 study. https://app.cochat.ai/papers/10.1016/s0140-6736(10)60172-9
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Scher, H. I., Beer, T. M., Higano, C. S., Anand, A., Taplin, M.-E., Efstathiou, E., Rathkopf, D., Shelkey, J., Yu, E. Y., Alumkal, J., Hung, D., Hirmand, M., Seely, L., Morris, M. J., Danila, D. C., Humm, J., Larson, S., Fleisher, M., & Sawyers, C. L. (2010). Antitumour activity of MDV3100 in castration-resistant prostate cancer: a phase 1–2 study. The Lancet. https://doi.org/10.1016/s0140-6736(10)60172-9

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

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