Thousands of men with advanced prostate cancer could live longer with a & # 39; precision drug & # 39; a large study suggests.
Lynparza extended the lives of men with an incurable form of the disease, who can withstand standard treatment.
The drug froze disease progression by an average of 7.4 months – more than double the hormone treatment currently being used.
Men who use the drug, also known as olaparib, lived for 18.5 months – about 3.5 months longer than the treatment used on the NHS.
It is the first proven drug for prostate cancer that can be adapted to the genetic make-up of a patient, instead of using an unambiguous approach.
Olaparib – used all over the world and on the NHS for ovarian cancer – focuses on detecting defective DNA that helps cancer cells repair and thrive.
Scientists have said the results are a & # 39; remarkable achievement & # 39; and could improve the lives of up to 10,000 British men.
Thousands of British men with advanced prostate cancer receive the first & # 39; precision drug & # 39; for their illness. Depicted, prostate cancer cells
Lynparza is intended for the treatment of men whose cancer does not respond to other therapies. Their cancer continues to grow and spread, which is ultimately fatal.
This is called metastatic castration-resistant prostate cancer (mCRPC). Scientists say there is a growing need for new and effective therapies for these patients.
It affects approximately 10 to 20 percent of prostate cancer patients within five years of their diagnosis – equivalent to between 4,000 and 10,000 men per year in the UK.
AstraZeneca, the manufacturer of Lynparza, conducted the drug test alongside the American pharmaceutical company MSD or Merck.
WHAT IS THE DRUG?
Lynparza is the brand name of the medicine olaparib.
It is a treatment for some people with ovarian cancer, ovarian cancer and peritoneal cancer that have a change in a gene called BRCA.
PARP – short for Poly (ADP-ribose) polymerase – is a protein that helps damaged cells repair themselves. Olaparib stops with PARP.
Some cancer cells rely on PARP to keep their DNA healthy. This includes cancer cells with a change in the BRCA gene.
When olaparib stops using PARP to repair DNA damage, the cancer cells die.
This is a type of targeted cancer medicine, called a growth inhibitor for cancer.
Source: Cancer Research UK
The phase three trial of the drug, called PROfound, was led by scientists from the Institute of Cancer Research in London and Northwestern University in Chicago.
They compared Lynparza – the brand name of the drug olaparib – with standard hormone treatments on the NHS, abiraterone and enzalutamide.
The disease progression was stopped for 7.39 months in men who used Lynparza, compared to 3.55 months with hormonal treatment.
Men lived 18.5 years when they were treated with Lynparza, compared to 15.1 months with hormone treatment.
Treatment with Lynparza resulted in a 66 percent greater delay in progression than the hormonal agents, the results also showed.
Dr. Eleni Efstathiou, MD Anderson Cancer Center, Houston, said: “This is impressive because it is significantly higher than the 35-40 percent improvements that we are very satisfied with in previous prostate cancer studies in this more advanced setting of diseases.
& # 39; There is a trend towards improved survival, but we have to wait for the final analysis. & # 39;
Study author Professor Maha Hussain, Northwestern University, said: “It is a remarkable achievement to see such a significant effect on disease progression and other clinically relevant effects such as pain progression and objective response.
& # 39; We saw the benefits of olaparib in all subgroups of patients, regardless of country, age, previous therapy and severity of the disease, also in patients with worse disease that had spread to their liver or lungs. & # 39;
Lynparza works by focusing on mutated BRCA genes – some of which have men in the study.
Men with a wider range of less well-studied defective DNA repair genes were also studied in the trial with similar results.
Cancer cells with a change in their genes rely on a protein called PARP, which helps damaged cells repair themselves. Lynparza blocks PARP, causing the cancer cells to die.
Hormonal treatment, on the other hand, lowers testosterone, the male sex hormone, which thrives on many prostate tumors.
When a man is diagnosed with prostate cancer, he can receive surgery, radiotherapy, chemotherapy or hormonal treatment.
But if the cancer spreads to other parts of the body and cannot be cured, the treatment is aimed at prolonging life and relieving symptoms.
Lynparza can work for men whose cancer has continued to grow and spread even when their testosterone levels have been medically reduced.
Professor Hussain said: & # 39; Prostate cancer has lagged behind all other common solid tumors when using molecular targeted treatment, so it's very exciting that we can now personalize the treatment of an individual based on specific genomic changes in their cancer cells & # 39;
The only down side to the findings is that side effects, such as anemia and nausea, were more common in patients taking Lynparza.
In total, 16.4% of patients taking Lynparza stopped treatment due to adverse events, compared to 8.5% with hormonal treatment.
Dr. Efstathiou said: & # 39; In general, these data show that, like breast and lung cancer, prostate cancer is not one, but many different diseases, and that we should start by identifying different groups of patients and treating them with targeted therapy & # 39;
Prostate cancer is the most common cancer in men with nearly 48,000 diagnoses a year in the UK and more than 1.2 million worldwide.
Dr. Matthew Hobbs, Deputy Director of Research at Prostate Cancer UK, said: & # 39; This hugely exciting outcome is a revolution in prostate cancer treatment.
& # 39; It is finally bringing prostate cancer drugs into the 21st century by first giving us a therapy that uses tumor genetic testing to find out which men will benefit from it.
& # 39; This kind of precision medicine approach is already being used to treat other cancers, and we hope that olaparib will be the first of many prostate cancer treatments based on this kind of detailed understanding of an individual man's tumor. & # 39;
The findings were presented at the ESMO 2019 conference in Barcelona.
WHAT IS PROSTATE CANCER?
Prostate cancer is the growth of tumors in the prostate gland.
Only men have a prostate, a walnut-sized gland between the rectum and the penis that creates a fluid that must be mixed with sperm to make sperm.
How many people does it kill?
More than 11,800 men a year – or one every 45 minutes – are now killed by prostate cancer in Britain, compared to around 11,400 women who die of breast cancer.
It means that prostate cancer is behind lung and intestinal tracts in terms of the number of people it kills in Britain. In the US, the disease kills 26,000 each year.
Nevertheless, it receives less than half of the research funding for breast cancer – while treatments for the disease are at least ten years behind.
How fast is it developing?
Prostate cancer usually develops slowly, so there can be no signs that someone has it for years, according to the NHS.
If the cancer is at an early stage and causes no symptoms, a policy of & # 39; can wait alert & # 39; or & # 39; active surveillance & # 39; are accepted.
Some patients can be cured if the disease is treated at an early stage.
But if it is diagnosed at a later stage, when it has spread, it becomes terminal and the treatment revolves around relieving symptoms.
Thousands of men are delayed to make a diagnosis because of the known side effects of the treatment, including erectile dysfunction.
Testing and treatment
Tests for prostate cancer are haphazard, with accurate tools that are just starting to show up.
There is no national prostate screening program because the tests have been too inaccurate for years.
Doctors have difficulty distinguishing between aggressive and less severe tumors, making it difficult to choose a treatment.
Men over 50 are eligible for a "PSA" blood test that gives doctors a rough idea of whether a patient is at risk.
But it is unreliable. Patients who receive a positive result usually receive a biopsy that is also not watertight.
Scientists are not sure what causes prostate cancer, but age, obesity, and lack of exercise are known risks.
Anyone with concerns can contact the Prostate Cancer UK specialist nurses on 0800 074 8383 or come to visit prostatecanceruk.org.
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