Blue Sky News - Prostate Cancer Foundation of Australia - April 2023

[marnieg46]

While, as has been the case for previous editions of this publication, most of the information is mainly relevant to readers from Oz, some items might be of interest to others.

Nuclear Medicine: The Next Generation of Care

For men generally with advanced prostate cancer, the future is theranostic, involving a combination of therapy and diagnostics to halt the spread of disease.  Clinical trials co-funded by Prostate Cancer Foundation Australia have proven that PSMA imaging is more accurate at detecting cancerous prostate cells than conventional imaging such as CT and bone scans – a discovery which enabled the listing of PSMA PET/CT on the Medicare Benefits Schedule in July 2022. 

Telix Pharmaceuticals, headquartered in Melbourne, has developed Australia’s first approved PSMA-PET imaging agent, known as Illuccix and is now working on a therapeutic compound for prostate cancer, also targeting PSMA.   Telix Group CEO and Managing Director, Dr Christian Behrenbruch says “We are currently running two major clinical trials in prostate cancer therapy in Australia and will commence the ProstACT GLOBAL Phase III study in advanced metastatic disease later this year.   Each of these will be underpinned by a new approach to patient engagement, promoting every man’s physical, mental and emotional health as well as treating the clinical disease.”

A New Day Dawns: Australian Experts Convene on Early Detection

A review of the Australia’s Clinical Guidelines for PSA testing was announced in November 2022 by the Prime Minister Anthony Albanese.   A 16-person Steering Committee has been formed to oversee Australia’s review of the guidelines for PSA testing, with an aim to modernise the way Prostate cancer diagnosis and treatment is managed.   The Steering Committee will be co-Chaired by Professor Jeff Dunn AO, PCFA’s Chief of Mission, and Adjunct Professor Peter Heathcote, a Past President of the Urological Society of Australia and New Zealand and one of Australia’s leading urological surgeons.  Australia has among the highest rates of prostate cancer in the world Professor Dunn says.   “We can save many lives if we simply detect the disease earlier, before it spreads outside the prostate.   New guidelines will help us do that.”

Facing the Genetic Tiger:  Expanding Access to gene Testing for Prostate Cancer

Since April 2022 AstraZeneca’s Lynparza (Olaparib) has been listed for eligible men with prostate cancer, responding to a length advocacy campaign by PCFA and others.  This has ensured thousands of men have benefitted from no-cost genetic test to determining eligibility for Lynparza which has been found to lower men’s risk of death by 37% compared to other forms of treatment.  In terms of treatment pathways, it is offered to men when their prostate cancer becomes resistant to other forms of treatment, which means it is important for men with advanced prostate cancer to undergo genetic testing early so that a decision can be made early whether to treat the tumour with Lynparza or other novel medicines. 

A Son’s Promise: Ending the Pain of Prostate Cancer

This is Shannan Gove’s story story of how his father, Tony, died from an aggressive form of prostate cancer at 63 and his own endeavour to help change the way Australia manages the disease.  While he agrees that a new set of Clinical Guidelines for PSA Testing will help address some issues,  but in the full scheme of things he maintains that research offers the most viable prospect for finding ways to effectively prevent, detect, treat and eliminate prostate cancer.  He argues for an equalisation of funding levels.   Prostate cancer receives only around half the funding poured into other major cancers, related largely to how different cancers are socialised in the Australian context, with action on breast cancer setting the high bar.    Shannan maintains that more funding would help accelerate new discoveries to resolve some of the puzzles and perhaps at a higher level, an even greater scale of investment could help defeat the disease altogether, delivering breakthroughs on a par with the creation of the cervical cancer vaccine for women.  

New Research:  Four Projects Making Prostate Cancer History 

The four projects are:

Targeting epigenetic changes in advanced prostate cancer 

Dr Joanna Achinger-Kawecka,  Garvan Institute of Medical Research

This project will help identify new epigenetic drivers of treatment resistant neuroendocrine prostate cancers (NEPCs) using emerging technologies and preclinical models to try to restore men’s response to treatment.   Hormone treatments targeting androgens are the current standard of care for men with metastatic prostate cancer, but many patients will experience the emergence of treatment resistant NEPCs over time.  The aim of the research is to help solve this problem.

Manipulating the Immune Response for Prostate Cancer Treatment

Dr Laura Porter, Monash University

This project will help advance more effective and targeted treatments for men with metastatic prostate cancer, using the immune system to eradicate prostate cancer proliferation with CAR T-cell therapy, whereby T-cells bind to cancer cells and destroy them.   To date, CAR T-cell has not proven effective against prostate cancer, but this research will seek to identify factors that strengthen the treatment response to slow the spread of prostate cancer and improve survival.

Developing a physiological prostate cancer model for rapid drug testing

Dr Kate Guan, University of New South Wales

This project will map the metabolic pathways involved in resistance to a specific type of hormone therapy and target identified pathways with metabolism inhibitors to restore treatment response in men with metastatic prostate cancer.   The research aims to identify metabolism-targeted agents that can effectively block anti-androgen resistance or synergise with anti-androgen treatments to improve survival outcomes. 

Inequalities in care and real-world outcomes for men with advanced prostate cancer

Dr Kerri Beckman, University of South Australia

This project will investigate therapies for men with metastatic prostate cancer to identify patterns of disadvantage.   It will also seek to better understand any adverse events and the survival outcomes related to different types of therapies.   The outcomes will inform best-practice care for men, advancing our work to overcome disparities such as 24% higher rate of death in regional areas. 

Link to April 2023 Edition of Blue Sky News

pcfa.org.au/media/792431/pc...

Items in Previous Edition – January 2023

-Personal Care Planning – Survivorship Care Plan  

-The Year of Alpha Therapy:  Lead -212

-Prostate Cancer Cost Blow-Out – A Call to Arms on ResearchCancer,

-Sex and Side-Effects:   Managing Erectile Dysfunction after Prostate Cancer

-Latest News:  Progress in Prostate Cancer from Around the World

Consensus grows:  Patient and cancer characteristics must be considered

Clinical Trials and Tribulations:  Promoting survivorship care in research studies

Bypassing biopsies: combined imaging helps detect clinically significant cancers

Transperineal v transrectal: A comparison of detection accuracy

Link to January Edition of Blue Sky News 

pcfa.org.au/media/792346/pc...

[cujoe]

Thanks, M, for providing another of your OZonian PCa info updates.

At least I can now read about a Blue Sky, even if I haven't been able to see much of one for the last several days. As with PSMA-scans/directed treatments, AU often seems years ahead of us here in the USA.

I also note that you have a fine following around HU who also appreciate your timely contributions. And I definitely need to get me one of those "Professor Joshua" MOs.

Hope all is well with your and your mate.

Ciao - K9

PS BTW, Are any of the mentioned projects ones you had a hand in getting funded?

[marnieg46 in reply to cujoe]

Thanks K9. Sorry about the cloudy weather. Maybe some sunshine for tomorrow.

Nope. None of the Peter Mac research projects I've been involved in were mentioned. Although it was hoped there might have been spin offs for PC as one as was in relation to TP53 and the other CAR T, neither were PC specific or funded by PCFA.

I'm working my way through the link from the PC, Nutrition and and Dietary Supplements article you posted the other day. It has a wealth of information that is only discovered by checking out the various 'links within the links'. A little gold mine. Well worth time spent exploring properly which I plan to do. More later...

[d3is4me]

Thanks Marnie a great deal of information we all need to extend our time for these treatments to become available

[MateoBeach]

Thanks Marnie. The research lines are of particular interest. Regards to Ron and Jo. Paul

[NPfisherman]

Hi Marnie,Thanks for the Blue Sky News...Finding a way to make CAR-T cells more effective by enhancing tumor cell penetration and reducing T cell fatigue is critical to making CAR-T a viable tx for solid tumors.

Hopefully, they will find metabolic targets that can work in conjunction with SOC to slow down/ stop the advancement of PCa. We need more than AR targeting to control PCa.

Good that they are looking at transperineal biopsies. The decreased risk for infection makes this a better choice. My brother had this as opposed to transrectal.

Hope all is well with you and yours...

DD

[marnieg46 in reply to NPfisherman]

Thanks Dave.

What struck me about this edition is it once again brings home the importance of funding for prostate cancer research and a reminder of the discrepancy, at least here, with funding for other cancers.

Family all well but Ron's taking a bit longer than usual to recover from another hospital stay for a UTI. A salient reminder of the need to avoid a build up of resistance to the regular antibiotics. This time they avoided administration with the continuous solution (?) he's usually hooked up to to avoid it going to his lungs as it did on his prior stay just before Christmas. What's Paul say? A true stoic!

Trust all goes well for you too and you're keeping well and fit as usual. Marnie

ps...We never see Pad that he doesn't ask about you and how you're going.

[NPfisherman in reply to marnieg46]

Marnie,

I agree that breast cancer research is much better funded than prostate cancer. Wishing Ron a rapid recovery.

Issues with Margaret's mom going for surgery, since she has a UTI. In Florida for Margaret's assignment with locum

tenens . Still waiting on my brother's next PSA.

As for Pad, tell him I still need money for my last treatment, and would appreciate any assistance.... lol ...

Keep Oz running right ...

Dave