Abiraterone Plus Leuprolide Offers Edge in M0 Hormone-Naive Prostate Cancer

Pearl Mccarthy
June 6, 2018

African-American men with advanced prostate cancer might be more responsive than white men to an anti-androgen drug and steroids, according to a study led by Duke Cancer Institute researchers. However, more than a third of those men who have been treated with a new drug, could stop the proliferation of malignant cells. These are medications which boost the immune system, and here trials have shown combination treatments to have have saved the lives of some men who were diagnosed with terminal prostate cancer.

Eleni Efstathiou, MD, and colleagues at The University of Texas MD Anderson Cancer Center in Houston, studied 197 patients with M0HNPC randomly assigned to receive AA plus leuprolide (99 men) for 8 months or leuprolide alone (98 men).

Professor Johann de Bono, director of the drug development unit, 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".

"This is the first evidence that a subset of prostate cancer patients do spectacularly well on immunotherapy".

While only 5% of men in the trial saw their tumours shrink or disappear after treatment, many of those had mutations in genes involved in repairing DNA in their tumours.

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"In the previous few years immunotherapy has modified the way in which we deal with many superior cancers - however so far nobody had demonstrated a profit in males with prostate most cancers". It is an IgG4 isotype antibody that blocks a protective mechanism of cancer cells, and allows the immune system to destroy those cancer cells. The immunotherapy is used for the treatment of cancers of the advanced stage including the cancers of lung and melanoma.

Some patients whose bodies were riddled with cancer have had "Lazarus-like" recoveries - and now show no visible signs of disease 18 months or more later, according to the doctor leading research into the treatment. However, the researchers were expecting it, since immunotherapy only works for some patients.

"One of the major challenges with immunotherapy is that we don't have many reliable tests to pick out who will benefit", Workman said.

The researchers also said that some of the patients who had substantial responses to the treatment have tumors that may have mutations in the genes that control DNA fix, an important cellular process that maintains the genome.

Researchers found those with the best response had types of prostate cancer with "ultra-mutant cancer cells" which change their genetic make-up quickly.

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