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Two new treatment options found to be effective for advanced prostate cancer

Prostate cancer researchers dedicate their lives working in labs and clinics, collaborating with colleagues, designing experiments and trials… all with one big goal in mind: to help patients. Whether it’s exploring the biology of cancer in the lab or conducting clinical trials with patients, research eventually converges into better treatments.

What is nmCRPC? Non-metastatic castration-resistant prostate cancer is a clinical state in which men who are being treated with androgen deprivation therapy (ADT) see their PSA levels begin to rise (indicating the cancer has become resistant to ADT and is starting to grow again), but no metastases are visible yet on scans. What is mHSPC? Patients with metastatic hormone-sensitive prostate cancer have cancer that has spread beyond the prostate and have not yet been treated with ADT.

But how are these discoveries communicated to practicing doctors? The urologist who takes your blood for your PSA usually has little to do with the doctor who developed the test. One way that information is spread is through major scientific conferences: several times a year, researchers, clinicians, science writers, experts from the pharmaceutical industry, patient advocates, and, of course, leaders from PCF gather under one roof for a few information-packed days to present and discuss the most important developments in the prostate cancer field. Everyone comes away inspired – a researcher plans to try a new approach to a vexing challenge in her lab, a doctor sees a new treatment coming to market that could help his patients in the next few months.

In February, the team at PCF attended the Genitourinary Cancers Symposium in San Francisco. No cable cars or Ghirardelli chocolate for us – we spent our days in presentations. We are very excited to share news about two important developments in treating advanced prostate cancer.

  1. A new drug, darolutamide, a second-generation androgen receptor (AR) inhibitor, may soon be a new treatment option for patients with non-metastatic castration-resistant prostate cancer (nmCRPC). Dr. Karim Fizazi of the Institut Gustave Roussy and the University of Paris shared results which demonstrated that adding darolutamide to ADT delayed metastasis or death (whichever came first) by an average of 22 months compared with the addition of a placebo. This represents a 59% reduction of risk for metastasis or death for patients with nmCRPC. It is too soon to know the impact of this treatment on overall survival, but there is a positive trend, suggesting a nearly 30% reduction in the risk of death. If approved by the FDA, darolutamide would become a third option for patients with nmCRPC, in addition to the current drugs apalutamide and enzalutamide, both of which were FDA-approved last year for the treatment of nmCRPC in combination with ADT.
  2. Patients with metastatic “hormone-sensitive” prostate cancer (mHSPC) may soon have another option to slow the growth of their cancer. PCF Young Investigator Dr. Andrew Armstrong of the Duke University School of Medicine and Duke Cancer Institute presented results showing that the addition of enzalutamide to ADT reduced the chances of tumor growth on scans or death (whichever came first) by 61% compared with a placebo, in men with mHSPC. This was seen in different types of mHSPC patients – those who had high and low levels of metastases, and whether or not they had already been treated with docetaxel. Again, it is too early to measure total survival, but the results appear somewhat positive.

What does this information mean to patients with advanced prostate cancer? Both of these drugs are currently under review by the FDA for use in these specific disease states.  If approved, patients and their families will have more options to treat their disease.

PCF is proud to have funded the original synthesis of enzalutamide at UCLA by chemist Michael Jung, PhD, in collaboration with prostate cancer physician-scientist Charles Sawyers, MD (now at Memorial Sloan Kettering Cancer Center).

What is nmCRPC? Non-metastatic castration-resistant prostate cancer is a clinical state in which men who are being treated with androgen deprivation therapy (ADT) see their PSA levels begin to rise (indicating the cancer has become resistant to ADT and is starting to grow again), but no metastases are visible yet on scans. What is mHSPC? Patients with metastatic hormone-sensitive prostate cancer have cancer that has spread beyond the prostate and have not yet been treated with ADT.