Two Drugs Offer Hope Against Prostate Cancer

By Dennis Thompson

HealthDay Reporter

THURSDAY, Feb. 8, 2018 (HealthDay News) — Two cancer drugs can stall the progression of a particularly hard-to-treat form of prostate cancer, a pair of new trials shows.

Both a newly developed drug called apalutamide and an already approved drug called enzalutamide (Xtandi) kept prostate cancer from spreading for two years in men whose disease had not yet traveled to other parts of their bodies.

Men newly diagnosed with prostate cancer that hasn’t spread are first treated with androgen-deprivation therapy — a medication that robs the tumor of the testosterone that helps fuel its growth, said Dr. Matthew Smith, lead researcher of the apalutamide trial. He is director of the genitourinary malignancies program at Massachusetts General Hospital, in Boston.

“It always works, and it almost always stops working,” Smith said. “And when it stops working, that’s what we call castration-resistant prostate cancer.”

Until now, there have been no approved treatments for prostate cancer at that stage, Smith said. The men are put under observation until their cancer migrates, at which point treatment resumes.

Tens of thousands of men in the United States are estimated to be in this situation and they have a very poor prognosis, particularly if their levels of prostate-specific antigen (PSA) are rapidly rising, Smith said. PSA is a protein produced by the prostate; a sudden elevation of PSA levels has been linked to increased prostate cancer risk.

“There’s an unmet need there,” Smith said. “Their expected survival is similar to that of men with newly diagnosed prostate cancer that has already spread to bone.”

Both apalutamide and enzalutamide battle prostate cancer by binding to the androgen receptor on tumor cells, blocking its activation by testosterone and other male hormones, explained Dr. Oliver Sartor, medical director of the Tulane Cancer Center in New Orleans. He co-wrote a commentary accompanying the apalutamide trial.

“Both the drugs are incredibly similar to one another,” Sartor said. “If you look at the chemical structure, they’re extremely close to one another. Mechanistically, they operate the same way.”

Dual trials

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