Here's a copy of part of the Times article mentioned above plus another on PSMA and Radiotherapy.
'Giving a prostate cancer drug sooner to men with advanced disease can cut their risk of dying early by a third, a trial has found.
Enzalutamide reduced the chance of tumours growing by 60 per cent during the trial and now offers men an alternative to gruelling chemotherapy.
However, the drug is six times the cost of standard chemotherapy and is unlikely to be approved by the NHS until scientists can show that it dramatically improves quality of life. The drug is available on the NHS once hormone treatment fails.
Hormone therapy to reduce levels of testosterone, which fuels tumour growth, is the standard treatment for the roughly 10,000 men a year in Britain who are diagnosed with advanced prostate cancer. An international trial of 1,125 men looked at giving enzalutamide alongside hormone therapy and compared results to standard care.
In results presented to the annual meeting of the American Society for Clinical Oncology (Asco) in Chicago, 28 per cent of men on standard care died over three years compared with 20 per cent of those on enzalutamide.
Ian Davis of Monash University, who led the trial, said: “The benefits of enzalutamide had already been established for prostate cancers that are no longer responding to hormonal therapy. The actual result in patients starting hormonal therapy, noting patients had a 60 per cent improvement in the time it takes to detect the cancer growing again along with a 33 per cent increased chance of survival, was far higher than we expected.
“The survival benefit is substantially greater giving it at this stage than it is further down the track — you get much greater bang for your buck.”
Professor Davis said that although the four-times a day tablet had side effects such as hot flushes and tiredness, many men would prefer it to chemotherapy. “No one gets up in the morning and says ‘I really wish I could have chemotherapy,” he said. Enzalutamide, chemotherapy and the drug abiraterone are now “reasonable alternatives” for men whose tumours have spread, he added.
Neeraj Agarwal, of Asco, said: “We see here that giving enzalutamide early can offer worthwhile benefits, especially for certain groups of men. In addition to helping men live longer overall, this approach means they can also go longer without having to take steroids or receive chemotherapy.”
Matthew Hobbs, deputy director of research at Prostate Cancer UK said: “This is a positive trial that demonstrates the benefit of giving enzalutamide upfront to men diagnosed with advanced prostate cancer. However, it does not show that this is any more effective than the UK’s standard practice of giving docetaxel chemotherapy upfront in combination with hormone injections. We therefore expect that to remain standard UK practice.”
He said that further research to show which men would benefit most from the drug “should help lead to more personalised treatment decisions in the future.
In the meantime there are some men diagnosed with advanced prostate cancer who cannot have chemotherapy, and we want to see another treatment option made available to them so that they can benefit from the additional months of life that having abiraterone or enzalutamide can provide.”
The National Institute for Health and Care Excellence said it reviews “every three years any new evidence that could indicate that recommendations need updating.”'
There is also the article below on PSMA and Radiotherapy.
'Thousands of men with incurable prostate cancer are set to benefit from a “search-and-destroy” type of radiotherapy that doctors believe is “the next big thing” in treating the disease.
The method, which targets cancer cells with a nuclear payload, was hailed as potentially game-changing by experts at the world’s biggest cancer conference.
Although results are only now starting to emerge, doctors said that targeting radioactive chemicals precisely to kill tumour cells while avoiding side-effects could be a huge step for men with prostate cancer. Every year 47,000 British men develop the disease.
There is even hope that the method could one day be used earlier as an alternative to standard hormone therapies that effectively castrate patients.
A study of 43 men who had exhausted all other treatments at the Peter Mac Cancer Centre in Melbourne showed that 57 per cent responded to the drug and of those 82 per cent saw their tumours shrink. Arun Azad, a researcher at the centre who is testing the treatment on 200 men in one of ten trials around the world, said: “If the results are positive it will change the landscape of how we treat prostate cancer.”
Results are due next year from a final-stage study which it is hoped will show that the method cuts deaths by a quarter.
At the annual meeting of the American Society of Clinical Oncology in Chicago, Professor Johann de Bono of the Institute of Cancer Research in London, who is joint leader of the trial, said the new form of radiotherapy was “a huge deal”. “It is one of the next big things,” he said. “There is no doubt it is causing substantially durable remission, and we are optimistic.”
A similar approach is used to detect the spread of cancer using scans. Chemicals that show up on the scans target a protein called PSMA, which is found on the surface of prostate tumours. Doctors use the same method of seeking out PSMA to attach radiation-emitting chemicals to tumour cells. “Essentially what you have is a bullet instead of a light,” said Professor Stefano Fanti of the University of Bologna.'
https://www.thetimes.co.uk/edition/news/prostate-cancer-cells-blitzed-with-search-and-destroy-radiotherapy-d0ssdfq9g
I assume it's OK to post these for non-commercial learning.
Edited by member 03 Jun 2019 at 23:35
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