Tasquinimod

Tasquinimod is an oral quinoline-3-carboxamide that acts on the tumour microenvironment: it binds S100A9, has anti-angiogenic and immunomodulatory effects, and was intended to work where drugs aimed at the androgen receptor had stopped working.

A randomised phase 2 trial improved progression-free survival, and 10TASQ10 was designed to confirm it. It assigned 1,245 chemotherapy-naive men with metastatic castration-resistant prostate cancer and bone metastases 2:1 to tasquinimod (832) or placebo (413) at 241 sites in 37 countries. Median radiographic progression-free survival by central review was 7.0 months (95 percent confidence interval 5.8 to 8.2) with tasquinimod and 4.4 months (3.5 to 5.5) with placebo, hazard ratio 0.64 (0.54 to 0.75, p<0.001).

Median overall survival went the other way: 21.3 months (19.5 to 23.0) with tasquinimod and 24.0 months (21.4 to 26.9) with placebo, hazard ratio 1.10 (0.94 to 1.28, p=0.25). Grade 3 or worse adverse events were more frequent with tasquinimod (42.8 against 33.6 percent), the commonest being anaemia, fatigue and cancer pain. Active Biotech and Ipsen stopped the programme in prostate cancer.