Dr. Robert J Amato is now with our Lord

[Cmdrdata]

Just heard from his research assistant that Dr Robert Amato passed away Friday Sept. 6, 2019. To many PC patient including myself, he was one of the most caring and excellent Oncologist, prolific and true genitourinary cancer researcher in finding a “cure” for our disease. He will be missed by many of his patients. Please pray for his family.

[Bunkerboy]

RIP Dr. Amato🙏🏻 My condolences to his family.

[NPfisherman]

I believe this MD gave Gourd Dancer his cure....A "think out of the box Oncologist"... we need more of those... May God bless his family and give them strength at this time of great sorrow....

Don Pescado

[cigafred]

I visited with him once, to apply for an apalutamide clinical trial, and he was the most energetic, outgoing doctor I have ever encountered. Was very surprised when, a short time later, he announced his withdrawal from practicing due to his medical condition.

[curious-mind1]

Very sad to hear this.

[ronnie1943]

Prayers for Dr.Amato and family. 🙏🏻

[Hidden]

Sad to hear of the passing of a real difference maker to our brethren.

[j-o-h-n]

A quote from one of his patients:

“Cancer is not a wonderful thing to go through but having a great doctor makes all the difference in the world,” Bender says. “Dr. Amato could tell me he’s moving to Mars and I’d move there with him.”

May he rest in Peace.... Condolences to his family, relatives, friends and patients...

j-o-h-n Tuesday 09/10/2019 7:37 PM DST

[Cmdrdata]

The obituary: legacy.com/obituaries/houst...

[Hidden]

Cmdrdata, I will see you at the funeral. Dr. A saved my life and I will forever be grateful. I really enjoyed our visits since 2004, some 40 plus. Usually we talked about life and the fun things that we did to enjoy. Reflecting, on my first meeting with him, he spent 2 1/2 hours with me looking at and comparing my previous scans; how cancer survives, then he explained his trial. I enrolled and had a port put in and the rest is history. I remember this comment: “We knew how to kill cancer in 1978, the trick is how to kill the cancer without killing the patient first during the treatment. I believe that I am there.”

I hope that a new bright research medical oncologist picks up where he left off in genitourological cancers. In my opinion and according to his statistics, those who received his protocol every early were cured of metastatic prostate cancer; those who received it later were given a huge extension of life. If the cancer is too invasive attacking vital organs, cure is not an option - only extension of life. The cancer that he had occurred in a major organ and he knew the odds of cure were nil. However, his research oncologist managed to more than double his expected survival.

Gourd Dancer

[cigafred in reply to Hidden]

What was his protocol? When I saw him about the apalutamide trial (it never got going, this was well before his own cancer) he thought intermittent apalutamide was a likely cure, and he quickly lost me with a lot of molecular diagrams on his white board.

[Hidden in reply to cigafred]

Apalutamode was one of the silver bunkers should I have needed it.

Trial of chemotherapy plus hormonal therapy as initial treatment for unresectable or metastatic adenocarcinoma of the prostate

Robert Amato and Haby Henary

DOI: Published May 2005

Proc Amer Assoc Cancer Res, Volume 46, 2005

Abstract

5748

Background: The delivery of chemotherapy in a setting of hormone refractory prostate cancer has shown palliative benefit, with substantial PSA decline, strongly suggesting that disease modifying potential exists. Recently, chemotherapy is being reported to show a survival advantage. The stage is set for chemotherapy to be given earlier in men with prostate cancer. As a working hypothesis, transformation from an androgen-dependent to an androgen-independent phenotype is mediated by the expansion of an androgen-independent clone already present at the time of androgen deprivation. If this model is correct, then it would be desirable to bring treatment to bear on the androgen-independent component when the corresponding tumor burden is minimal. We view the androgen-independent component as analogous to “microscopic residual” or micro-metastatic disease for which adjuvant chemotherapy has shown to be effective in other contexts. Methods: Each course of chemotherapy lasts for 8 weeks (6 on/2 off). Patients were treated on weeks 1, 3, and 5 with adriamycin 20 mg/m2 as a 24-hour intravenous infusion on the first day of every week in combination with ketoconazole 400 mg orally 3 times a day, daily for 7 days. On weeks 2, 4, and 6, treatment consisted of docetaxel 35 mg/m2 intravenously over 1 hour on the first day of every week in combination with estramustine 280 mg orally 3 times a day, daily for 7 days. Hormone therapy, GnRH antagonist, is initiated within the 3 months of initiating chemotherapy. After the completion of 3 courses of chemotherapy, the addition of casodex occurs. Hormone management continues for a total of 24 months. At the completion of 24 months of hormone therapy, then discontinued. Men are then followed every 12 weeks with a serum PSA, including testosterone level. For those men who have a PSA recurrence, hormone therapy will be reinitiated. Results: Nineteen men have been enrolled, to date, with a median age of 63 (range 48-76) years. Fifty percent of the men had no prior local therapy, while the other 50% either failed surgery, radiation therapy, or surgery plus radiation therapy. Fifty-nine percent of the men had Gleason 7, 12%/8, 24%/9, and 5%/10. Thirty-five percent of the men presented with bone metastasis and 50% presented with nodal involvement. The median PSA reduction to date has been 96% with associated nodal and bone scan improvement. Conclusion: Enrollment is ongoing. Further information regarding PSA response with associated radiographic response and toxicity will be presented.

* American Association for Cancer Research

Cancer Chemother Pharmacol. 2013 Jun;71(6):1629-34. doi: 10.1007/s00280-013-2163-4. Epub 2013 Apr 21.

A phase II trial of androgen deprivation therapy (ADT) plus chemotherapy as initial treatment for local failures or advanced prostate cancer.

Amato R1, Stepankiw M, Gonzales P.

Author information

1

Division of Oncology, Department of Internal Medicine, University of Texas Health Science Center at Houston (Medical School)/Memorial Hermann Cancer Center, 6410 Fannin St., Suite 830, Houston, TX 77030, USA. [e-mail]

Abstract

PURPOSE:

Long-term hormonal ablation in prostate cancer is associated with decreased overall health and quality of life. Few reports emphasized the role of chemotherapy in the management of early stage prostate cancer. This study analyzed the safety and efficacy of androgen deprivation therapy (ADT) plus chemotherapy as initial treatment for patients identified as local failures or not eligible for prostatectomy or radiation therapy due to advanced disease presentation.

METHODS:

Enrolled patients received ADT in the form of leuprolide every 12 weeks for 24 months with bicalutamide initiating after the completion of chemotherapy. Chemotherapy consisted of ketoconazole and doxorubicin for weeks 1, 3, and 5 and estramustine and docetaxel and for weeks 2, 4 and 6. During weeks 7 and 8, no treatment was received.

RESULTS:

Forty-six patients were enrolled, and forty-five patients were evaluable. Median progression-free survival (PFS) was 23.4 months. Median overall survival (OS) was 53.7 months. Out of 45 patients with measurable disease, 22 patients had an objective response: 9 patients achieved a complete response; 2 patients achieved a partial response; 10 patients achieved stable disease. Frequent grade 3 adverse events included elevated ALT (17 %), hypokalemia (13 %), and hypophosphatemia (13 %). Grade 4 adverse events were rare and included low bicarbonate (2 %), hypokalemia (2 %), leukocytopenia (2 %), and neutropenia (2 %).

CONCLUSIONS:

The treatment demonstrated clinical benefit in all patient subsets with minimal reversible treatment-related adverse events. Subgroup analysis suggests that having prior local therapy resulted in greater PFS and OS.

[cigafred in reply to Hidden]

Thank you

[Cmdrdata in reply to cigafred]

The apalutamide clinical trial that I was considered for was NCT02811809. This study was delayed several times and then he got ill. My recollection during my conversation with him was that apalutamide was a third generation antiandrogen, and lab tests have also indicated that it has the capability of causing cancer apoptosis (causes cell death) and thus the promise of it being better than Zytiga or Xtandi.

Whenever I visited him (Dallas to Houston) for checkups and treatments, we talked a lot about new and upcoming treatments, and I shared with him that my goal in seeking PC treatment with him was to advance the treatment of PC, not just to prolong my own life. Some of our visits are just a few minutes, but other times he spent almost an hour talking back and forth, while the waiting room is still full of people. I never complain waiting for my appointed time, because I know that he spent as much time with others as needed.

[cigafred in reply to Cmdrdata]

Yes, that is the trial. Dr. Amato was running a couple of hours late when I got in to see him in the late afternoon, but still he spent about an hour explaining to me the benefits of apalutamide with numerous molecular diagrams which were pretty much wasted on me. What puzzled me was that everyone was smiling that day because they had just finalized/signed all documentation for the trial and expected to start in a few days, but it never started. It was maybe a year later when Dr. Amato announced his withdrawal from practice.

[GeorgeGlass in reply to Cmdrdata]

I'm searching some past posts and stumbled upon this one. Sad to hear that Dr. Amato passed on. He sounded like a doctor that everyone would want to call their own doc. Did anyone with the same treatment protocols and philosophy take his place at their hospital?