A recent University of Montreal study is giving renewed hope in the battle against prostate cancer.
Results of a Phase 1 clinical trial conducted at the University of Montreal Hospital Research Centre (CRCHUM) show that a new drug combination may work to slow the progression of treatment-resistant metastatic prostate cancer, the most advanced form of prostate cancer.
The study, presented this year at the American Society of Clinical Oncology, looked at patients prescribed both abiraterone acetate, commonly administered for metastatic prostate cancer, along with a drug not yet approved for market, labelled JNJ-56021927. The combination of the two has produced encouraging results.
“Our trial conducted on forty patients indicates that this treatment is safe. The combined drugs are well tolerated and the treatment appears effective,” says Dr. Fred Saad, principal investigator of the study.
Prostate cancer is the most common cancer among men in Canada, excluding non-melanoma skin cancers. The Canadian Cancer Society reports that 24,000 Canadian men this year (and one in eight over the course of their lifetime) will be diagnosed with the disease. One in 27 will die from it. Worldwide, prostate cancer accounts for 15% of cancers in men and 7.9% of cancers overall.
In general, prostate cancer has a very good survival rate and responds well to treatment. For 5% of detected cases, however, prostate cancer is in the advanced metastatic stage where survival rates fall dramatically.
The CRCHUM study will now move to a Phase 3 clinical study involving 960 patients in 196 hospitals around the world. It will take another three years to complete.
“We hope to find a well-tolerated and effective treatment to slow the progression of prostate cancer in men with advanced prostate cancer,” says Dr. Saad.
Early detection is key but screening for prostate cancer has become murky territory. In 2014 the Canadian Task Force on Preventive Health Care told Canadian physicians it no longer recommends routine screening for the prostate-specific antigen, or PSA, the most common screening test for prostate cancer.
Once upheld as key to men’s health and widely endorsed by public figures – everyone from Larry King to Calgary’s Naheed Nenshi were seen urging men to get tested – the routine PSA is now felt to be not only ineffective in preventing deaths due to prostate cancer but it can also lead to overdiagnosis and unnecessary treatment. Especially for men 70 years of age and older, prostate cancer is common but rarely life threatening or even problematic – at this age one is more likely to die with prostate cancer than from it.
There are obvious benefits to screening when it serves to catch later stage, metastatic cancers, but the relative rarity of this form of prostate cancer combined with the costs and risks of unnecessary treatment have led to the recent shift away from routine screening.
Both the Canadian Cancer Society and the American Cancer Society now advocate that screening should be advised on a case by case basis and that men talk to their physician before deciding whether to take the PSA test.