A British trial has for the first time shown that state-of-the art immunotherapy can be used to target prostate tumours.
The study at the Royal Marsden Hospital in London found more than a third of men who had run out of existing options were still alive and one in ten had not seen their tumours grow after a year of taking Pembrolizumab, which targets a gateway helps the immune system to attack cancer cells.
For some in the group, the drug even caused their tumours to shrink.
Funded by the Institute of Cancer Research, the team will now set out to identify the genes that will tell them which people are most likely to benefit from the drug.
Previous trials using immunotherapy in prostate cancer have been unsuccessful but the latest research examined the genetics of the tumours and found particular groups of patients may benefit.
While only 5 per cent of men in the trial saw their tumours shrink or disappear after treatment, many of those had mutations in genes involved in repairing DNA.
The researchers suggest these mutating cancer cells may be easy for the immune system to recognise and attack because they look different from healthy cells.
Data from some other cancer types, such as bowel, has similarly shown tumours with defects in DNA repair mutations are more susceptible to immunotherapy.
“It’s exciting that immunotherapy could offer some men more time with their loved ones”Prof Johann de Bono
Professor Johann de Bono, Director of the Drug Development Unit at The Institute of Cancer Research, said: “I have these men who are basically dying, with weeks to months to live, who we gave this drug to and had complete responses.
“Their cancers shrunk, disappeared actually, with minimal cancer left on scans.”
He added: “These are amazing results, and these are men whose cancers had all the treatments, they had everything possible, they’ve got no treatments left, and they are in trouble.
“They have very short life spans left.”
He added: “In the last few years immunotherapy has changed the way we treat many advanced cancers – but up to now no one had demonstrated a benefit in men with prostate cancer.
“Our study has found that immunotherapy can benefit a subset of men with advanced, otherwise untreatable prostate cancer, and these are most likely to include patients who have specific DNA repair mutations within their tumours.
“It’s exciting that immunotherapy could offer some men more time with their loved ones where they have such advanced disease that they have run out of existing treatment options.”
Around 47,000 men are diagnosed with prostate cancer each year in the UK, with 11,631 deaths from the disease.
Overall, survival is good for the cancer, with 84 per cent still alive 10 years after first diagnosis.
However, for patients such as those in the new study with docetaxel-refractory metastatic castration-resistant prostate cancer, there is currently no effective treatment.
Former BBC Breakfast host Bill Turnbull has become the second public figure to speak about their prostate cancer diagnosis in recent weeks, after Stephen Fry’s announcement in February. Turnbull, who says his cancer is incurable and has spread to his bones, has urged men to get checked as soon as they notice something suspicious. The BBC presenter says he had experienced aches and pains for a year and noticed a change in his “pee pattern” but attributed it to “old age”, before finally seeing a doctor.
Prostate cancer rates are continuing to rise, and statistics revealed earlier this month month by Prostate Cancer UK show that the cancer has now become a bigger killer than breast cancer for the first time. More than 11,800 men a year (that’s one person every 45 minutes) are now killed by the disease in the UK, compared with about 11,400 women dying of breast cancer.
In Fry’s case, he appears to have been fortunate. While on a visit to get the flu-jab from his doctor last December, he decided to also have a routine check-up where he was told that his PSA (Prostate-Specific Antigen) levels were higher than normal. His doctor recommended an MRI scan, followed by a biopsy, where the cancer was discovered. It had been caught relatively early, and Fry underwent an operation. Fry has since been informed by doctors that “it’s all been got”.
Prostate cancer still only receives half the research funding of breast cancer and men with prostate cancer have to wait four times longer for a diagnosis than women with breast cancer with the average diagnosis coming after 126 days. The best way to combat prostate cancer is to know the symptoms inside out. As such, we have compiled a list of everything you need to know about prostate cancer. If you think you are showing signs of prostate cancer consult your GP immediately.
What does the prostate do?
The prostate’s main job is to create some of the fluid found in semen. It weighs about 20 grams and is the size of a chestnut.
What is prostate cancer?
Healthy cells usually divide and die, but cancer cells keep multiplying. When they build up, they cause a cancer. This process is much the same in the prostate as elsewhere in the body.
Who’s at risk?
Men over 50. The average age for diagnosis is between 65 and 69. Most men under 50 are not at risk, but the probability is higher if you are black.
It’s also believed to be hereditary so you’re more at risk if a relative has had the cancer.
What are the symptoms?
Prostate cancer can go unnoticed for a long time – which is part of the problem when it comes to treating it, as the cancer can be quite developed before it is identified.
The most common symptoms are to do with urination. That includes needing to urinate more frequently and difficulties trying to urinate, such as a weak flow. Other symptoms include needing to rush to the bathroom a lot, as well as feeling that you are not emptying your bladder completely. Another symptom is waking up at night to urinate.
Less common symptoms include pain when urinating or ejaculating, as well as blood in urine and semen.
What’s the test?
A PSA test – a blood test for levels of a prostate-specific antigen – can suggest you have a problem with your prostate, though not necessarily cancer. A DRE (digital rectal examination) is also used to test for prostate problems. The doctor or nurse will feel the prostate through the rectum. There might be momentary discomfort but it’s over quickly.
The only way to know that it is cancer for certain is with a biopsy, which will also hopefully reveal how aggressive the cancer is. The most common type of biopsy in the UK is a TRUS (transrectal ultrasound), where small pieces of tissue are taken from different areas of the prostate.
It takes about ten minutes. The results provide a Gleason grade which should show how likely a cancer is to spread. There are five grades; anything above grade two is cancer.