Nav: Home

First prostate cancer therapy to target genes delays cancer progression

September 30, 2019

  • 'We are now entering a new era of precision medicine for metastatic prostate cancer'
  • Drug extends time to disease progression and potentially survival time, delays time to pain progression
  • There are an estimated 174,650 new cases of prostate cancer with 31,620 deaths in the U.S. in 2019
CHICAGO --- For the first time, prostate cancer has been treated based on the genetic makeup of the cancer, resulting in delayed disease progression, delayed time to pain progression, and potentially extending lives in patients with advanced, metastatic prostate cancer, reports a large, international phase 3 trial. One of the principal investigators is from Northwestern Medicine.

The PROfound trial treated men with metastatic prostate cancer that has progressed after several types of prior therapies, including hormone therapy.

This marks a significant advance for prostate cancer treatment, which has lagged behind other common cancers with regard to precision therapy, now the standard of care in breast, ovarian and lung cancers.

"Treatments for metastatic, hormone-resistant prostate cancer have continued to use 'one-size-fits-all' approaches, overlooking the genetic make-up of the tumor," said Northwestern principal co-investigator Dr. Maha Hussain.

"Our results show the potential of a genetically targeted treatment for patients with advanced disease," Hussain said. "I am confident we are now entering a new era of personalized care and precision medicine for metastatic prostate cancer."

Hussain is a professor of medicine at Northwestern University Feinberg School of Medicine and deputy director of the Robert H. Lurie Comprehensive Cancer Center of Northwestern University. She also is a Northwestern Medicine medical oncologist.

The results will be presented Sept. 30 during the Presidential Symposium at the 2019 European Society of Medical Oncology in Barcelona.

In 2019, there are an estimated 174,650 new cases of prostate cancer in the U.S., and 31,620 deaths from the disease, according to the National Cancer Institute. In 2016, there were an estimated 3,100,000 men living with prostate cancer in the U.S.

The trial preselected patients who have genetic alterations in the genes that enable cells to repair themselves from damage. Those most commonly known are the BRACA 1, BRACA 2 and ATM genes, but there are several others. Patients were randomly assigned to receive olaparib, which has been used in other cancers (ovarian, breast and pancreatic) with similar alterations - or standard hormone therapy with either abiraterone and prednisone or enzalutamide.

Olaparib blocks PARP, which is a protein that helps damaged cells repair themselves. Some cancer cells rely on PARP to keep their DNA healthy. When PARP is stopped from repairing DNA damage, the cancer cells die.

"We want to prevent those renegade cancer cells from repairing themselves," Hussain said.

There were two cohorts of patients based on the type of genetic alteration.

mage that must be repaired in order for the cancer cells to keep growing.

Patients in cohort A (with alterations in BRACA 1, BRACA 2 or ATM) who took olaparib had a significant extension of time before the disease grew and spread. The average time before the disease progressed was more than double: 7.4 months for the olaparib-treated patients compared to 3.6 months for the group of patients who were treated with standard hormone therapy of abiraterone and prednisone or enzalutamide.

At six months following treatment in this same cohort, about 60% of the men receiving olaparib showed no disease progression compared to 23% in the control groups. After 12 months, about three times as many men on olaparib remained progression free (28% compared to 9% in the control groups). The control groups received standard hormone treatments used for prostate cancer. As soon as men in the control groups showed disease progression, they were given olaparib.

The benefit was across the board, irrespective of the patient's cancer location, prior treatment, where the cancer had spread (bone, liver or lymph nodes), the patient's PSA (prostate-specific antigen) or age.

When prostate cancer spreads to the bone, it can cause significant pain. When patients received the drug, they had a longer time before pain occurred or progressed, Hussain said.

Scientists are still following patients who will ultimately die from their cancer, but the drug appears to prolong survival. The percentage of patients alive at six, 12 and 18 months is higher with the drug. One-year survival was 73% for the drug versus 56.94% for the control group; at 18 months, survival was 56.3 % for the drug versus 42.13% for the control group.

Trends were similar in cohort B, which was composed of a different group of genetic alternations, but were not as powerful as cohort A.
-end-
The study was funded by AstraZeneca and Merck & Co., which produces olaparib under the name Lynparza.

More News at Northwestern Now

Find experts on our Faculty Experts Hub

Follow @NUSources for expert perspectives

http://news.feinberg.northwestern.edu/tag/press-release/

Northwestern University

Related Prostate Cancer Articles:

First prostate cancer therapy to target genes delays cancer progression
For the first time, prostate cancer has been treated based on the genetic makeup of the cancer, resulting in delayed disease progression, delayed time to pain progression, and potentially extending lives in patients with advanced, metastatic prostate cancer, reports a large phase 3 trial.
Men taking medications for enlarged prostate face delays in prostate cancer diagnosis
University of California San Diego School of Medicine researchers report that men treated with medications for benign prostatic hyperplasia (enlarged prostate) experienced a two-year delay in diagnosis of their prostate cancer and were twice as likely to have advanced disease upon diagnosis.
CNIO researchers confirm links between aggressive prostate cancer and hereditary breast cancer
The study has potential implications for families with members suffering from these types of tumours who are at an increased risk of developing cancer.
Distinguishing fatal prostate cancer from 'manageable' cancer now possible
Scientists at the University of York have found a way of distinguishing between fatal prostate cancer and manageable cancer, which could reduce unnecessary surgeries and radiotherapy.
Researchers find prostate cancer drug byproduct can fuel cancer cells
A genetic anomaly in certain men with prostate cancer may impact their response to common drugs used to treat the disease, according to new research at Cleveland Clinic.
ASCO and Cancer Care Ontario update guideline on radiation therapy for prostate cancer
The American Society of Clinical Oncology (ASCO) and Cancer Care Ontario today issued a joint clinical practice guideline update on brachytherapy (internal radiation) for patients with prostate cancer.
Patient prostate tissue used to create unique model of prostate cancer biology
For the first time, researchers have been able to grow, in a lab, both normal and primary cancerous prostate cells from a patient, and then implant a million of the cancer cells into a mouse to track how the tumor progresses.
Moffitt Cancer Center awarded $3.2 million grant to study bone metastasis in prostate cancer
Moffitt researchers David Basanta, Ph.D., and Conor Lynch, Ph.D., have been awarded a U01 grant to investigate prostate cancer metastasis.
Prostate cancer discovery may make it easier to kill cancer cells
A newly discovered connection between two common prostate cancer treatments may soon make prostate cancer cells easier to destroy.
New test for prostate cancer significantly improves prostate cancer screening
A study from Karolinska Institutet in Sweden shows that a new test for prostate cancer is better at detecting aggressive cancer than PSA.
More Prostate Cancer News and Prostate Cancer Current Events

Top Science Podcasts

We have hand picked the top science podcasts of 2019.
Now Playing: TED Radio Hour

Risk
Why do we revere risk-takers, even when their actions terrify us? Why are some better at taking risks than others? This hour, TED speakers explore the alluring, dangerous, and calculated sides of risk. Guests include professional rock climber Alex Honnold, economist Mariana Mazzucato, psychology researcher Kashfia Rahman, structural engineer and bridge designer Ian Firth, and risk intelligence expert Dylan Evans.
Now Playing: Science for the People

#541 Wayfinding
These days when we want to know where we are or how to get where we want to go, most of us will pull out a smart phone with a built-in GPS and map app. Some of us old timers might still use an old school paper map from time to time. But we didn't always used to lean so heavily on maps and technology, and in some remote places of the world some people still navigate and wayfind their way without the aid of these tools... and in some cases do better without them. This week, host Rachelle Saunders...
Now Playing: Radiolab

Dolly Parton's America: Neon Moss
Today on Radiolab, we're bringing you the fourth episode of Jad's special series, Dolly Parton's America. In this episode, Jad goes back up the mountain to visit Dolly's actual Tennessee mountain home, where she tells stories about her first trips out of the holler. Back on the mountaintop, standing under the rain by the Little Pigeon River, the trip triggers memories of Jad's first visit to his father's childhood home, and opens the gateway to dizzying stories of music and migration. Support Radiolab today at Radiolab.org/donate.