I'm looking more closely at those bone scan images, and I found accompanying PD, SD, PR, CR, and NE data.
PD=7, SD=9, PR=5, CR=1, and NE=3
If you do a google search under sunitinib bone scan response images, and select images the top of images page will display baseline and 12 bone scan images of 3 best responders. It also includes x and y axis charting of PSA changes and bone response category.
It doesn't specifically state sunitinib, but it is pretty obvious the images are from that study. There is a title describing multitargeted tyrosine kinase inhibit...
I have to admit the 3 best responses are impressive, but when you consider the 7 patients with progressive disease, it is obvious that sunitinib's effect is not nearly as consistent.
Sunitinib had HR of .9 for survival. Not statistical, but favoring suntinib arm in post docetaxel population. Discrepancy between 2 different sites I looked at. One ASCO post displayed .4 month sunitinib OS benefit, and another site displayed 1.8 month differential. I couldn't really find any pain data, as I was pretty curious. In any event, very difficult to cross compare pain data. Even moreso than any other cross trial comparison. Quadramet for example had 60-70% pain reduction, and randomized trial for pain alleviation is very confusing to what scoring I have seen with Cabo thusfar. Quadramet has large quantity of salvage stage patients with bone pain palliation, but difficult to decipher extent.
Sunitinib/Prednisone Improves Progression-free Survival but not Overall Survival in Metastatic Castrate-resistant Prostate Cancer
A total of 873 men were randomized to receive sunitinib (n = 584) or placebo (n = 289). Median age was 68 years, and 49% of patients had a Gleason score ≥ 8. The trial was stopped after a second futility analysis in September 2010. In data collected through February 2011, the median treatment duration was 3.7 months (range, 0−23.2) on the sunitinib arm and 3.4 months (range, 0−22.1) on the placebo arm. Progression-free survival was significantly greater on the sunitinib arm than the placebo arm (5.6 vs 3.7 months; HR = 0.74; P = .0022), although overall survival was not significantly different (13.1 vs 11.7 months; HR = 0.91; P = .1630, stratified log-rank test for both). The overall response rate with sunitinib was also significantly higher compared with placebo (6.1% vs 1.8%; P = .04).
So it seems that some subset patient pops may realize benefit wrt bone turnover.
I remember this trial, and also remember looking for expert responses.
Those that I found were dismissive...from Philip W. Kantoff, MD, of the Dana-Farber Cancer Institute, who emphasized that this was essentially a negative study.
“There is no evidence that VEGFR-targeted agents provide a survival benefit for men with advanced prostate cancer,” he indicated. “With shrinking resources and a rapidly improving understanding of the genetic and biologic basis of disease, we need to be more selective about what agents to bring forward to be tested in the phase III setting” said Dr. Kantoff."
The chart with x and y graphs of PSA and bone response clearly displays it is data from Journal of Nuclear Medicine, but it will not let me enter into the visit page site. I am certain the data is displaying sutinib treated patients. Plus 5 PR's and 1 CR among 24 patients isn't coincidental.