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Prostate cancer vaccines more effective with hormone therapy
July 10, 2008PHILADELPHIA - Among patients with castration-resistant prostate cancer, the addition of hormone therapy following vaccine treatment improved overall survival compared with either treatment alone or when the vaccine followed hormone treatment, according to recent data published in the July 15 Clinical Cancer Research, a journal of the American Association for Cancer Research.
Philip M. Arlen, M.D., director of the Clinical Research Group for the Laboratory of Tumor Immunology and Biology, Center for Cancer Research, at the National Cancer Institute, said the findings have important implications for guiding treatment decisions for prostate cancer patients.
"Vaccines, if and when they are approved, can be safely and effectively combined with other therapies, including hormones," said Arlen. "There appears to be an advantage in overall survival."
Arlen and colleagues enrolled 42 patients who had castration-resistant prostate cancer. These patients were randomly assigned to receive either a poxvirus-based prostate-specific antigen vaccine or hormone therapy with nilutamide. At progression, patients received the other therapy and continued to receive their original therapy.
For all the patients enrolled in the study, the three-year survival probability was 71 percent and the median overall survival was 4.4 years. Patients randomized to the vaccine had a three-year survival probability of 81 percent and an overall survival of 5.1 years, while patients taking nilutamide had a three-year survival probability of 62 percent and an overall survival of 3.4 years.
Of the 42 patients in the study, 12 patients who were originally assigned to vaccine switched to nilutamide plus vaccine and eight patients who were originally assigned to nilutamide switched to vaccine plus hormone, due to rising levels of prostate-specific antigen with no evidence of metastasis. For patients who received vaccine and then nilutamide, the three-year survival probability was 100 percent with a median overall survival of 6.2 years. For patients who switched to the vaccine after hormone, the three-year survival probability was 75 percent with a median overall survival of 3.7 years.
Arlen said the hormone therapy in combination with the vaccine works in two ways.
"By using hormone therapy in prostate cancer you can help enhance your T-cell response to where the cancer is in the prostate gland, and you are also more likely to achieve a better immune response," said Arlen.
Building on the results of this phase II study, researchers have developed another generation of this vaccine by adding molecules which boost T-cell responses.
Based on the current pace of vaccine research overall, Arlen predicts that men with prostate cancer could potentially see an effective, new treatment vaccine within the next several years.
"Phase II trials such as this one are adding to our knowledge, and other phase III trials are getting ready to publish their data," said Arlen. "If the phase II data hold up in phase III trials, we could see a new treatment vaccine within a few years."
American Association for Cancer Research
Arlen and colleagues enrolled 42 patients who had castration-resistant prostate cancer. These patients were randomly assigned to receive either a poxvirus-based prostate-specific antigen vaccine or hormone therapy with nilutamide. At progression, patients received the other therapy and continued to receive their original therapy.
For all the patients enrolled in the study, the three-year survival probability was 71 percent and the median overall survival was 4.4 years. Patients randomized to the vaccine had a three-year survival probability of 81 percent and an overall survival of 5.1 years, while patients taking nilutamide had a three-year survival probability of 62 percent and an overall survival of 3.4 years.
Of the 42 patients in the study, 12 patients who were originally assigned to vaccine switched to nilutamide plus vaccine and eight patients who were originally assigned to nilutamide switched to vaccine plus hormone, due to rising levels of prostate-specific antigen with no evidence of metastasis. For patients who received vaccine and then nilutamide, the three-year survival probability was 100 percent with a median overall survival of 6.2 years. For patients who switched to the vaccine after hormone, the three-year survival probability was 75 percent with a median overall survival of 3.7 years.
Arlen said the hormone therapy in combination with the vaccine works in two ways.
"By using hormone therapy in prostate cancer you can help enhance your T-cell response to where the cancer is in the prostate gland, and you are also more likely to achieve a better immune response," said Arlen.
Building on the results of this phase II study, researchers have developed another generation of this vaccine by adding molecules which boost T-cell responses.
Based on the current pace of vaccine research overall, Arlen predicts that men with prostate cancer could potentially see an effective, new treatment vaccine within the next several years.
"Phase II trials such as this one are adding to our knowledge, and other phase III trials are getting ready to publish their data," said Arlen. "If the phase II data hold up in phase III trials, we could see a new treatment vaccine within a few years."
American Association for Cancer Research
Hormone Therapy Current Events and Hormone Therapy News RSSScientists uncover new key to the puzzle of hormone therapy and breast cancer
The use of postmenopausal hormone therapy has decreased over time in the United States, which researchers suggest may play a key role in the declining rate of atypical ductal hyperplasia, a known risk factor for breast cancer.
Short-term hormone therapy and intermediate dose radiation increases survivial for early stage prostate cancer
Short-term hormone therapy given prior to and during intermediate dose radiation treatment for men with early stage prostate cancer increases their chance of living longer, compared to those who receive the same radiation alone.
Study shows hormone replacement therapy decreases mortality in younger postmenopausal woman
Hormone replacement therapy (HRT) to treat menopausal estrogen deficiency has been in widespread use for over 60 years. Several observational studies over the years showed that HRT use by younger postmenopausal women was associated with a significant reduction in total mortality; available evidence supported the routine use of HRT to increase longevity in postmenopausal women.
Hormone mix could cut breast cancer risk and treat symptoms of menopause
The right combination of estrogen and a selective estrogen receptor modulator (SERM), which blocks the effects of estrogen in breast tissue, could relieve menopause symptoms and cut breast cancer risk.
Breast tenderness during hormone replacement therapy linked to elevated cancer risk
Women who developed new-onset breast tenderness after starting estrogen plus progestin hormone replacement therapy were at significantly higher risk for developing breast cancer than women on the combination therapy who didn't experience such tenderness, according to a new UCLA study.
Women with breast cancer have low vitamin D levels
Women with breast cancer should be given high doses of vitamin D because a majority of them are likely to have low levels of vitamin D, which could contribute to decreased bone mass and greater risk of fractures, according to scientists at the University of Rochester Medical Center.
Researchers believe hormone therapy should not be stopped prior to mammograms
Researchers from Boston University School of Medicine (BUSM) are recommending that menopausal women on hormone therapy (HT) continue their treatment prior to having their annual mammogram screenings.
Prostate cancer patients on hormone therapy at increased risk for various heart diseases
New research has found that hormone therapy used to treat men with advanced prostate cancer is associated with an increased chance of developing various heart problems. Some choices of therapy appear, however, to be less risky than others.
Long-term tamoxifen use increases risk of an aggressive, hard to treat type of second breast cancer
While long-term tamoxifen use among breast cancer survivors decreases their risk of developing the most common, less aggressive type of second breast cancer, such use is associated with a more than four-fold increased risk of a more aggressive, difficult-to-treat type of cancer in the breast opposite, or contralateral, to the initial tumor.
Hormone therapy for prostate cancer patients with heart conditions linked to increased death risk
Men with coronary artery disease-induced congestive heart failure or heart attack who receive hormone therapy before or along with radiation therapy for treatment of prostate cancer have an associated increased risk of death.
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