Advanced Prostate Cancer: Research Update

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From treatment vaccines to changes in the medicines you're taking right now, scientists are working to find new treatments for prostate cancer.

They build on the "complete revolution in the treatment of advanced prostate cancer" in recent years, says Gary M. Kirsh, MD, president of The Urology Group in Cincinnati, OH.

Kathryn Bylow, MD, agrees. She's a cancer researcher at the Froedtert & the Medical College of Wisconsin Clinical Cancer Center. "When I first started in this field in 2003, we only had basic hormone therapy and chemotherapy," she says.

Making the Most of Hormone Therapy

Some of the most exciting research focuses on how and when to best use two drugs, abiraterone acetate (Zytiga) and enzalutamide (Xtandi). They bring testosterone levels down to almost nothing, which starves prostate cancer cells of that hormonal fuel. But they do it differently.

Xtandi works by blocking hormones called androgens from fueling tumor cells. Zytiga blocks the production of androgens everywhere in the body. Both drugs are approved for men with advanced prostate cancer that doesn’t respond well to traditional hormone therapy before chemotherapy.

"These drugs are making a real difference for patients in clinic today," says Tomasz M. Beer, MD, deputy director of the Knight Cancer Institute at Oregon Health & Science University in Portland, OR.

Researchers are now looking into whether combining both drugs and giving them at an earlier stage of the disease can help you live longer. Studies are also testing "how cancer gets around them, so we can target the resistance mechanisms," Beer says.

New Treatment Vaccines

You may have heard of sipuleucel-T (Provenge), a vaccine that uses your own white blood cells to destroy prostate cancer cells. Now, studies are underway to see if radiation, hormone therapy, or an experimental cancer vaccine called pTVG-HP helps Provenge work better.

Researchers are also studying cancer vaccines that contain viruses to harness the ability of the immune system -- your body's defense against germs -- to fight advanced prostate cancer.

Blood Test to Help Find Your Best Treatment

Scientists are working to develop a blood test to predict who is likely to benefit the most from these new treatments, Beer says.

The test measures signs in your blood that can forecast if your cells will resist new drugs such as Xtandi and Zytiga. This blood test may help your doctor understand when you should go on chemotherapy and when it's safe to hold off.

Checkpoint Inhibitors

A "checkpoint inhibitor treatment" called ipilimumab (Yervoy) may hold promise, too. It wakes up "checkpoints" in your body's immune system defenses, letting your T-cells take on cancer.

It's approved to treat metastatic melanoma, which is the deadliest form of skin cancer. Research is underway to see if the drug works in men with prostate cancer. Studies are also going on that combine ipilimumab with Provenge, hormone therapy, and prostate removal surgery.

Researchers are also studying other checkpoint inhibitors, including:

•Atezolizumab (Tecentriq)

•Nivolumab (Opdivo)

•Pembrolizumab (Keytruda)

WebMD Feature

Reviewed by Laura J. Martin, MD on December 10, 2016

Sources

© 2014 WebMD, LLC. All rights reserved.

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