New Drug For Advanced Prostate Cancer
Lowers Testosterone in Men With No Other Alternatives
The drug is approved for the treatment of the symptoms of advanced prostate cancer in men who cannot take other hormone therapies and refuse surgical castration. Removal of the testicles is one way of significantly lowering the levels of the male sex hormone testosterone, which can spur the growth of prostate cancer.
Because of an increased risk of serious, and potentially life-threatening, allergic reactions associated with Plenaxis, the drug will be restricted to men with advanced prostate cancer who have no alternative treatment. About 5%-10% of men with prostate cancer have the type of advanced, symptomatic disease that would make them eligible for Plenaxis.
New Radiation Therapy For Prostate Cancer Reduces Deaths Study Shows
By the time Michael Rosenblums prostate cancer was discovered, it was already at a late stage. Hed initially sought medical help because of excruciating back pain, but, during an exam, doctors found a tumor on his spine and tests revealed a skyrocketing prostate-specific antigen, or PSA, score. Chemotherapy didnt help much, so when doctors offered the opportunity to be in a clinical trial for a new experimental treatment, Rosenblum jumped at it.
The trial was investigating a new, potentially groundbreaking type of treatment for prostate cancer, a therapy that specifically targets a protein on the cancer cells. The treatment, part of a new class of liquid radiation drugs, obliterates most prostate cancer cells without hurting the surrounding tissue.
Its wonderful. I have no symptoms or anything, said Rosenblum, a 75-year-old retiree, who was diagnosed four years ago. He participated in the clinical trial at Memorial Sloan Kettering Cancer Center in New York. “My PSA went from 100 … to zero.
Higher PSA levels suggest that prostate cells are growing, which may indicate cancer.
Results from the trial Rosenblum participated in were released Thursday ahead of the annual meeting of the American Society of Clinical Oncology. The study finds that the new drug reduced the risk of death by 38 percent in patients with advanced prostate cancer. Progression of the disease was reduced by 60 percent.
The patients who received the new drug got it intravenously once every six weeks.
When To Begin Adt
Perhaps with this goal in mind, an increasing number of clinicians have been tempted to use ADT as primary treatment, despite the lack of evidence supporting this approach. Nobody has ever shown improvement in survival with partial or complete androgen deprivation therapy done early in the disease, except for some trials that combined ADT with external beam radiotherapy, Levine said.
If youve got an earlier stage prostate cancer, the chances are you are going to live at least 15 to 20 years, she said. And androgen deprivation therapy, particularly if it is very potent, is associated with a lot of side effects. It can cause metabolic syndrome, osteoporosis, poor quality of life, fatigue, decreased libido, and increased cardiovascular mortality. So its a balancing game. It hasnt been shown that if you begin it earlier that you improve overall survival except in very specific circumstances.
Because many of the side eff ects are the direct result of the absence of androgens, it is unlikely that the new agents will lessen them. With other drugs in the pipeline, the new generation will likely be a ripe area for research into the best sequences to give them, best combinations to use, integration with older drugs, and timing of delivery. Considering that this is a disease for which you really had no new drugs on the market that were useful for decades, its a very exciting time, Knudsen said.
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Promising New Treatment Strategy For Men With Drug
A new experimental drug could offer a promising approach to treating men with advanced prostate cancer which does not respond to existing treatments, or develops resistance to them, researchers report.
Their study reveals the chemical structure of a new targeted drug known as CCS1477 and its method of action and suggests it could be used to stop the growth of late-stage prostate cancers.
CCS1477 is now being evaluated in clinical trials as a monotherapy for patients with prostate cancer, and also in combination with existing drugs like enzalutamide and abiraterone. Researchers hope it can help to delay or prevent resistance to these treatments.
Potential to treat prostate cancerThe new research, pioneered by a team at The Institute of Cancer Research, London, and the Royal Marsden NHS Foundation Trust, has unveiled the drugs mechanism of action explaining how CCS1477 acts on its targets and highlighting its potential to treat prostate cancer.
CCS1477 was discovered by Cambridge-based CellCentric Ltd. The study is published in the journal Cancer Discovery and was funded by the Prostate Cancer Foundation, Movember, Prostate Cancer UK, Cancer Research UK and CellCentric Ltd. Other collaborators on the study include researchers from the Sidney Kimmel Cancer Center at Thomas Jefferson University, Philadelphia.
Re-activating p300 and CBP in patient samples turned back on signalling through the androgen receptor and c-Myc, helping fuel the growth of cancer cells.
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The drug has been approved for men with advanced prostate cancer who have a BRCA1 and/or BRCA2 genetic mutation and have stopped responding to abiraterone or enzalutamide.
The charity called on the Scottish Government to urgently release more funding and carry out testing more widely.
Olaparib represents a revolution in prostate cancer treatment and were delighted that men in Scotland will soon be able to benefit from its life-extending effects, said Dr Matthew Hobbs, Director of Research at Prostate Cancer UK.
However, without investment in vital genomic testing services, hundreds of men wont be able to access the tests they need to find out if they could benefit from this drug.
Today, were urging the Scottish government to make more funding available for BRCA testing, to ensure no man misses out on the chance of additional months of life.
Rob Jones, Professor of Clinical Cancer Research at the University of Glasgow, said it is essential that testing is widened.
“For these men, olaparib could delay the need for chemotherapy and extend survival, potentially making a real
difference to their lives, he said.
“It is now essential that men with this type of prostate cancer have access to BRCA testing to determine their eligibility for treatment.
A Scottish Government spokesperson said: In our Programme for Government, we committed to invest in our NHS Genetic Laboratories and frontline genetics services in order to embed genomics medicine into routine healthcare.
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Treating Prostate Cancer That Has Spread To The Bones
Doctors are studying the use of radiofrequency ablation to help control pain in men whose prostate cancer has spread to one or more areas in the bones. During RFA, the doctor uses a CT scan or ultrasound to guide a small metal probe into the area of the tumor. A high-frequency current is passed through the probe to heat and destroy the tumor. RFA has been used for many years to treat tumors in other organs such as the liver, but its use in treating bone pain is still fairly new. Still, early results are promising.
Your Cancer Care Team
People with cancer should be cared for by a multidisciplinary team . This is a team of specialists who work together to provide the best care and treatment.
The team often consists of specialist cancer surgeons, oncologists , radiologists, pathologists, radiographers and specialist nurses.
Other members may include physiotherapists, dietitians and occupational therapists. You may also have access to clinical psychology support.
When deciding what treatment is best for you, your doctors will consider:
- the type and size of the cancer
- what grade it is
- whether the cancer has spread to other parts of your body
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Physical Emotional And Social Effects Of Cancer
Cancer and its treatment cause physical symptoms and side effects, as well as emotional, social, and financial effects. Managing all of these effects is called palliative care or supportive care. It is an important part of your care that is included along with treatments intended to slow, stop, or eliminate the cancer.
Palliative care focuses on improving how you feel during treatment by managing symptoms and supporting patients and their families with other, non-medical needs. Any person, regardless of age or type and stage of cancer, may receive this type of care. And it often works best when it is started right after a cancer diagnosis. People who receive palliative care along with treatment for the cancer often have less severe symptoms, better quality of life, and report that they are more satisfied with treatment.
Palliative treatments vary widely and often include medication, nutritional changes, relaxation techniques, emotional and spiritual support, and other therapies. You may also receive palliative treatments similar to those meant to get rid of the cancer, such as chemotherapy, surgery, or radiation therapy.
Before treatment begins, talk with your doctor about the goals of each treatment in the treatment plan. You should also talk about the possible side effects of the specific treatment plan and palliative care options.
How Is Prostate Cancer Diagnosed
Prostate cancer may be suspected based on your symptoms or the results of a screening test.
Screening is when your doctor looks for cancer before you have any symptoms. This can help find cancer at an early stage when it may be easier to treat. Two of the most frequently used screening tests used today include the digital rectal exam and the prostate-specific antigen test.
- A digital rectal exam is an exam of the rectum where the doctor inserts a lubricated, gloved finger into the lower part of the rectum to feel for lumps or enlargement in the prostate gland.
- A prostate-specific antigen is a blood test that measures levels of PSA in your blood. However, PSA is reasonably nonspecific and high levels may be associated with prostate cancer, prostatitis , or an enlarged prostate gland. Very high levels of PSA .
There is controversy over whether screening tests should be used at all. The USPSTF recommends men aged 55 to 69 have a discussion with their doctor about the pros and cons of PSA screening to determine if it is an appropriate preventive test for them. For men aged 70 and older, the USPSTF does not recommend PSA screening.
The American Cancer Society, recommends early-detection screening starting at age 40 or 45 if men are at high risk or age 50 in men at average risk.
In some cases, a prostate biopsy or imaging test like an ultrasound or magnetic resonance imaging may also be used to rule out cancer.
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Cancer That Is Thought To Still Be In Or Around The Prostate
If the cancer is still thought to be just in the area of the prostate, a second attempt to cure it might be possible.
After surgery: If youve had a radical prostatectomy, radiation therapy might be an option, sometimes along with hormone therapy.
After radiation therapy: If your first treatment was radiation, treatment options might include cryotherapy or radical prostatectomy, but when these treatments are done after radiation, they carry a higher risk for side effects such as incontinence. Having radiation therapy again is usually not an option because of the increased potential for serious side effects, although in some cases brachytherapy may be an option as a second treatment after external radiation.
Sometimes it might not be clear exactly where the remaining cancer is in the body. If the only sign of cancer recurrence is a rising PSA level , another option for some men might be active surveillance instead of active treatment. Prostate cancer often grows slowly, so even if it does come back, it might not cause problems for many years, at which time further treatment could then be considered.
Factors such as how quickly the PSA is going up and the original Gleason score of the cancer can help predict how soon the cancer might show up in distant parts of the body and cause problems. If the PSA is going up very quickly, some doctors might recommend that you start treatment even before the cancer can be seen on tests or causes symptoms.
Prostate Cancer: Thousands Of Men To Benefit From New Drug Approved For Use On Nhs
So far enzalutamide has been used as a so-called “COVID-friendly” cancer drug as patients can take it at home.
Tuesday 8 June 2021 06:21, UK
Thousands of men are set to benefit from a new prostate cancer drug which has been approved for use on the NHS.
The National Institute for Health and Care Excellence has recommended enzalutamide as an option for treating some types of the disease.
Prostate Cancer UK said the news was welcome for thousands of men, especially those who are unable to have chemotherapy.
The drug has been used during the pandemic as a so-called “COVID-friendly” cancer drug, which patients can take at home instead of needing intravenous medication in a health setting.
Now new draft guidance from Nice should enable wider use.
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The guidance says the drug, also known as Xtandi and made by Astellas, can be used with androgen deprivation therapy , as an option for treating hormone-sensitive metastatic prostate cancer in adults.
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Big Treatment News: Enzalutamide Approved For Men With Advanced Prostate Cancer
After three years of appraisals, were thrilled this life-extending drug is permanently available for men diagnosed with advanced prostate cancer.
The NHS answered our call to make enzalutamide temporarily available as a safer alternative to chemotherapy during the pandemic, and now todays decision finally gives thousands of men each year permanent access to a life-extending treatment. A huge win, thanks in part to your ongoing support.
This is particularly important for the 4,100 men each year who are unsuitable for the standard treatment of docetaxel chemotherapy and who have, until now, had limited treatment options.
Enzalutamide is as effective as chemotherapy in extending lives, giving these men a vital alternative treatment option. Those who can receive chemotherapy should discuss their options with their clinician to make an informed choice about which treatment is right for them.
What is enzalutamide and who is it for?
Enzalutamide is a medicine used to treat men with advanced prostate cancer. It wont cure prostate cancer, but it can help keep it under control and has been shown to help some men live longer.
It has long been routinely available to men whose cancer has stopped responding to other types ofhormone therapy and more recently has been shown to be as effective as docetaxel chemotherapy for men with advanced prostate cancer that is still responding to hormone therapy.
Men will have more time with their families.
Read more on enzalutamidehere.
Cancer That Clearly Has Spread
If the cancer has spread outside the prostate, it will most likely go to nearby lymph nodes first, and then to bones. Much less often the cancer will spread to the liver or other organs.
When prostate cancer has spread to other parts of the body , hormone therapy is probably the most effective treatment. But it isnt likely to cure the cancer, and at some point it might stop working. Usually the first treatment is a luteinizing hormone-releasing hormone agonist, LHRH antagonist, or orchiectomy, sometimes along with an anti-androgen drug or abiraterone. Another option might be to get chemotherapy along with the hormone therapy. Other treatments aimed at bone metastases might be used as well.
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Thousands Of Uk Men To Benefit After Nhs Approves Prostate Cancer Drug
Enzalutamide, which can be taken at home, is especially beneficial to those who cannot have chemotherapy
Thousands of men in the UK with advanced prostate cancer are to benefit from a new drug after it was approved for NHS use.
The National Institute for Health and Care Excellence has recommended enzalutamide as an option for treating some types of prostate cancer.
A spokesperson for Prostate Cancer UK said: Enzalutamide will be made permanently available for men in England, Wales and Northern Ireland, while men in Scotland will have access to a similar treatment called abiraterone.
Experts welcomed the move which they said would be especially beneficial to those who cannot have chemotherapy.
Enzalutamide, which patients can take at home without intravenous medication or a medical setting, is one of the Covid-friendly cancer drugs adopted by NHS England during the pandemic as swaps for existing drugs because they are less likely to damage the immune system or cause hospital visits.
Clinical trials have found that the treatment slows the worsening of the disease and extends patients lifespans.
Throughout the last year, the NHS has been offering people with cancer treatment options that are not only effective but safer and more convenient for use during the pandemic, allowing many to take medication at home or be given medicines with less harmful effects on their immune system.
Targeted Radioligand Improves Survival In Advanced Prostate Cancer
Cancer researchers say they have established a new, life-extending treatment option for men with prostate cancer that has spread and become resistant to hormone therapy. The injected treatment combines a targeting compound with a radioactive isotope to irradiate and kill cancer cells.
An international clinical trial sponsored by Endocyte, Inc., a Novartis company tested the targeted radioligand therapy in study participants with advanced prostate cancer. All subjects had cancers that had spread to other organs and continued to progress after previous treatment with two kinds of drugs, androgen axis inhibitors and taxanes. The experimental treatment significantly extended survival, delayed progression and was generally well tolerated by study subjects, researchers said.
This is a completely new treatment option that extends life and disease control in metastatic castration-resistant prostate cancer the most aggressive and deadly type, said Tom Beer, M.D., one of the study leaders and deputy director of the Oregon Health & Science University Knight Cancer Institute.
The added option is particularly important, Beer said, because the existing most effective treatments developed for metastatic castration resistant prostate cancer are now being used to treat early-stage disease.
Some of our best treatments are being used earlier, so by the time you get to metastatic castration resistant disease, you have fewer options, he said.
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