Monday, January 23, 2023

Experimental Treatments For Prostate Cancer

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Help Getting Through Cancer Treatment

New Prostate Cancer Treatment

People with cancer need support and information, no matter what stage of illness they may be in. Knowing all of your options and finding the resources you need will help you make informed decisions about your care.

Whether you are thinking about treatment, getting treatment, or not being treated at all, you can still get supportive care to help with pain or other symptoms. Communicating with your cancer care team is important so you understand your diagnosis, what treatment is recommended, and ways to maintain or improve your quality of life.

Different types of programs and support services may be helpful, and can be an important part of your care. These might include nursing or social work services, financial aid, nutritional advice, rehab, or spiritual help.

The American Cancer Society also has programs and services including rides to treatment, lodging, and more to help you get through treatment. Call our National Cancer Information Center at 1-800-227-2345 and speak with one of our trained specialists.

Treating Advanced Prostate Cancer

If the cancer has reached an advanced stage, it’s no longer possible to cure it. But it may be possible to slow its progression, prolong your life and relieve symptoms.

Treatment options include:

  • hormone treatment

If the cancer has spread to your bones, medicines called bisphosphonates may be used. Bisphosphonates help reduce bone pain and bone loss.

Zen003694 And Enzalutamide Versus Enzalutamide Monotherapy In Metastatic Castration

open to eligible males ages 18 years and up

This is an open-label, randomized, Phase 2b study of ZEN003694 in combination with enzalutamide vs. enzalutamide monotherapy in patients with mCRPC who have progressed on prior abiraterone by PCWG3 criteria. Disease must have progressed on only abiraterone by PCWG3 criteria prior to study entry. The patient population will be separated into two cohorts: Cohort A: Patients with poor response to prior abiraterone defined as: – Abiraterone started in hormone-sensitive prostate cancer disease setting: < 12 months duration on abiraterone or failure to achieve PSA nadir of 0.2 ng/mL while taking abiraterone, or – Abiraterone started in castrate-resistant prostate cancer disease setting: < 6 months duration on abiraterone or failure to achieve PSA50 response while on abiraterone Cohort B: Patients with response to prior abiraterone, defined as: – Abiraterone started in hormone-sensitive prostate cancer disease setting: ⥠12 months duration on abiraterone and nadir PSA < 0.2 ng/mL, or – Abiraterone started in castrate-resistant prostate cancer disease setting: ⥠6 months duration on abiraterone and confirmed PSA50 response

San Francisco, California

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The Indicate Study Treating Prostate Cancer That Has Come Back After Surgery With Apalutamide And Targeted Radiation Based On Pet/ct Imaging

Do you have prostate cancer that has returned after prostatectomy? If so, you may be able to participate in this study of potential new treatment approaches. In the EA8191/INDICATE study, all participants will receive the usual treatment for prostate cancer that recurs after surgery, which is radiation therapy to the prostate bed and pelvic lymph nodes, combined with short-term androgen deprivation therapy , also sometimes referred to as hormone therapy. In addition:

Some patients will receive additional PET/CT imaging, depending on the results of their initial PET/CT scan. Some patients will also receive a type of hormone therapy called apalutamide, which is approved by the FDA for treatment of your prostate cancer. Some patients, depending on the results of their initial PET/CT scan, will receive metastasis-directed radiation therapy.

To decide which of these approaches is better, doctors on the study team will be looking to see if your cancer responds, and if it returns again, how much time passes after your treatment before it returns.

To learn more about this study and to find out if you may be eligible, please visit:

ClinicalTrials.gov identifier: NCT04423211

Just One Weapon Against Cancer

Localised prostate cancer

Before treatment with PLUVICTOTM is recommended, patients undergo a PSMA-PET/CT scan to determine if their tumor contains the PSMA target. If it does not, PLUVICTOTM would not be appropriate, explained Dr. Wong. At Duke we treat you as an individual. Each case is discussed among a multidisciplinary team of surgeons, radiation oncologists, medical oncologists, radiologists, and nuclear medicine specialists. He emphasized that PLUVICTOTM is not for everyone and is just one weapon in the arsenal for fighting cancer. Our team will determine how and if this new option fits in with all the others we offer.

Duke can provide PLUVICTOTM and other novel treatments because it is a Comprehensive Cancer Center with the latest advances in diagnosing and treating prostate cancer. Duke is also recognized as a Comprehensive Radiopharmaceutical Therapy Center of Excellence, which requires strict adherence to safety and treatment criteria that ensures the best care for patients.

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Expert Review And References

  • American Cancer Society. Treating Prostate Cancer. 2019: .
  • American Society of Clinical Oncology. Prostate Cancer. 2020: .
  • Tracy, CR. Prostate Cancer. eMedicine/Medscape 2020: .
  • PDQ® Adult Treatment Editorial Board. Prostate Cancer Treatment Patient Version. Bethesda, MD: National Cancer Institute 2020: .
  • PDQ® Adult Treatment Editorial Board. Prostate Cancer Treatment Health Professional Version. Bethesda, MD: National Cancer Institute 2020: .
  • National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Prostate Cancer . 2020: .
  • Zelefsky MJ, Morris MJ, Eastham JA. Cancer of the prostate. DeVita VT Jr., Lawrence TS, Rosenberg SA, eds.. DeVita, Hellman, and Rosenberg’s Cancer: Principles & Practice of Oncology. 11th ed. Philadelphia, PA: Wolters Kluwer 2019: 70: 1087-1136.
  • Parker C, Castro E, Fizazi K et al . Prostate cancer: ESMO clinical practice guidelines for diagnosis, treatmentand follow-up. Annals of Oncology. 2020: 31: 1119-1134. .

Ways To Protect Your Prostate

Prostate cancer often comes with age, bad genes, or just plain bad luckbut it’s still possible to chip away at your risk. Try these tactics.

1. Go on the Sauce

In a study in the American Journal of Clinical Nutrition, men who ate more than two servings of tomato sauce a week had a lower risk of prostate cancer than guys who ate less than a serving per month. Certain compounds in cooked tomatoes may shield DNA strands from breakage.

2. Drink Responsibly

New Finnish research finds that people who swig three alcoholic drinks a week or less have a lower risk of prostate cancer than heavy drinkers. As you metabolize alcohol, your body makes carcinogenic molecules, which are only okay in moderation.

3. Finally Quit Smoking

As if you needed another reason to give up the cigs, research finds that smokers are more likely to die of prostate cancer than those who never smoked. One factor is that carcinogens from tobacco smoke likely promote the creation of tumors.

4. Buy Into Beans

In a recent study in the British Journal of Nutrition, men who ate the most legumes had half the prostate cancer risk of those who ate the least. When your gut digests the fiber in beans, it decreases inflammation, which may play a key role in tumor development.

Read Also: Where To Go For Prostate Exam

New Radiation Therapy For Prostate Cancer Reduces Deaths Study Shows

By the time Michael Rosenblums prostate cancer was discovered, it was already at a late stage. Hed initially sought medical help because of excruciating back pain, but, during an exam, doctors found a tumor on his spine and tests revealed a skyrocketing prostate-specific antigen, or PSA, score. Chemotherapy didnt help much, so when doctors offered the opportunity to be in a clinical trial for a new experimental treatment, Rosenblum jumped at it.

The trial was investigating a new, potentially groundbreaking type of treatment for prostate cancer, a therapy that specifically targets a protein on the cancer cells. The treatment, part of a new class of liquid radiation drugs, obliterates most prostate cancer cells without hurting the surrounding tissue.

Its wonderful. I have no symptoms or anything, said Rosenblum, a 75-year-old retiree, who was diagnosed four years ago. He participated in the clinical trial at Memorial Sloan Kettering Cancer Center in New York. “My PSA went from 100 … to zero.

Higher PSA levels suggest that prostate cells are growing, which may indicate cancer.

Results from the trial Rosenblum participated in were released Thursday ahead of the annual meeting of the American Society of Clinical Oncology. The study finds that the new drug reduced the risk of death by 38 percent in patients with advanced prostate cancer. Progression of the disease was reduced by 60 percent.

The patients who received the new drug got it intravenously once every six weeks.

A Study Of Copanlisib Combined With Rucaparib In Patients With Metastatic Castration

Prostate Cancer

open to eligible males ages 18 years and up

This is a single arm Phase Ib/II, open label, safety, pharmacokinetic and efficacy clinical study in adult patients with metastatic castration-resistant prostate cancer . Patients will be treated with the combination of copanlisib and rucaparib for as long as the patient does not have clinically significant progressive disease and/or unacceptable toxicity and/or as long as the investigator deems that the patient is benefiting from treatment. Treatment may also be stopped if the patient withdraws consent, or study termination occurs.

San Francisco, California

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Platform Study For Prostate Researching Translational Endpoints Correlated To Response To Inform Use Of Novel Combinations

open to eligible males ages 18 years and up

This study is designed to evaluate multiple clinical hypotheses and mechanistically-defined combinations to evaluate the safety and efficacy of immunotherapy combinations in participants with mCRPC who have received prior secondary androgen receptor signaling inhibitor therapy .

San Francisco, California

Testing The Addition Of The Drug Apalutamide To The Usual Hormone Therapy And Radiation Therapy After Surgery For Prostate Cancer

open to eligible males ages 18 years and up

This phase III trial studies whether adding apalutamide to the usual treatment improves outcome in patients with lymph node positive prostate cancer after surgery. Radiation therapy uses high energy x-ray to kill tumor cells and shrink tumors. Androgens, or male sex hormones, can cause the growth of prostate cancer cells. Drugs, such as apalutamide, may help stop or reduce the growth of prostate cancer cell growth by blocking the attachment of androgen to its receptors on cancer cells, a mechanism similar to stopping the entrance of a key into its lock. Adding apalutamide to the usual hormone therapy and radiation therapy after surgery may stabilize prostate cancer and prevent it from spreading and extend time without disease spreading compared to the usual approach.

San Francisco, California and other locations

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Car T Therapy For Solid Tumors

The idea of training the bodys own immune system to fight cancer has percolated throughout the cancer landscape for years now. Dorff is especially excited about the promise of CAR T treatment: taking a patients immune, or T cells, reengineering them to recognize specific tumor-associated antigens and then reintroducing them as supercharged cancer killers.

Dorff calls the progress in CAR T therapy profound and revolutionary. The Food and Drug Administration has approved two CAR T products for blood cancers.

But solid tumors, including prostate cancer, present special challenges.

Unlike say, leukemia cells, which are fairly uniform, solid tumors are packed with a wide variety of different cells, which means a one-size-fits-all CAR T cell targeting one specific protein cant mount much of an attack. Also, tumors often display an immunosuppressant microenvironment which can counter the punch of a CAR T onslaught. Finally, theres the problem of toxicity. Some of the proteins targeted by CAR T cells also exist in healthy tissue.

Dorff is heavily immersed in research and clinical trials to address all these concerns.

We need to find a way to get the CAR T cells into the tumor with the right amount and find a way to kill tumor cells with different expressions, she said. And we need to reduce toxicity and the immunosuppressant response.

Prostate Active Surveillance Study

Fatigue During Radiation Therapy For Breast Cancer

open to eligible males ages 21 years and up

The Prostate Active Surveillance Study is a research study for men who have chosen active surveillance as a management plan for their prostate cancer. Active surveillance is defined as close monitoring of prostate cancer with the offer of treatment if there are changes in test results. This study seeks to discover markers that will identify cancers that are more aggressive from those tumors that grow slowly.

San Francisco, California

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Enzalutamide With Or Without Abiraterone And Prednisone In Treating Patients With Castration

Sorry, in progress, not accepting new patients

This randomized phase III trial studies enzalutamide to see how well it works compared to enzalutamide, abiraterone, and prednisone in treating patients with castration-resistant metastatic prostate cancer. Androgens can cause the growth of prostate cancer cells. Drugs, such as enzalutamide, abiraterone acetate, and prednisone, may lessen the amount of androgens made by the body.

San Francisco, California

Considering Complementary And Alternative Methods

You may hear about alternative or complementary methods that your doctor hasnt mentioned to treat your cancer or relieve symptoms. These methods can include vitamins, herbs, and special diets, or other methods such as acupuncture or massage, to name a few.

Complementary methods refer to treatments that are used along with your regular medical care. Alternative treatments are used instead of a doctors medical treatment. Although some of these methods might be helpful in relieving symptoms or helping you feel better, many have not been proven to work. Some might even be harmful.

Be sure to talk to your cancer care team about any method you are thinking about using. They can help you learn what is known about the method, which can help you make an informed decision.

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Treatment With Nivolumab And Ipilimumab Or Nivolumab Alone According To The Percentage Of Tumoral Cd8 Cells In Advanced Metastatic Cancer

Sorry, not currently recruiting here

This is an open-label, exploratory study to evaluate nivolumab with or without ipilimumab based on percentage of tumoral CD8 cells at the time of treatment in participants with varying advanced solid tumors. Participants who have a tumor with ⥠15% CD8 cells will receive nivolumab monotherapy, and participants who have a tumor with < 15% CD8 cells will receive ipilimumab in combination with nivolumab.

San Francisco, California

Staging Of Prostate Cancer

The Live Primary Cell Phenotypic Test (LPCP) for Prostate Cancer

Doctors will use the results of your prostate examination, biopsy and scans to identify the stage of your prostate cancer .

The stage of the cancer will determine which types of treatments will be necessary.

If prostate cancer is diagnosed at an early stage, the chances of survival are generally good.

Recommended Reading: Can Prostate Cancer Be Cured If It Has Spread

Genetic And Molecular Mechanisms In Assessing Response In Patients With Prostate Cancer Receiving Enzalutamide Therapy

Sorry, in progress, not accepting new patients

This phase II trial studies genetic and molecular mechanisms in assessing response in patients with prostate cancer receiving enzalutamide therapy. Androgens can cause the growth of prostate cancer cells. Antihormone therapy, such as enzalutamide, may lessen the amount of androgens made by the body. Studying samples of tissue and blood in the laboratory from patients with prostate cancer may help doctors better understand castration-resistant prostate cancer. It may also help doctors make improvements in prostate cancer treatment.

San Francisco, California

Hormone Therapy For Prostate Cancer

Over the last few years, several new approaches to hormone therapy for advanced or metastatic prostate cancer have been approved for clinical use.

Many prostate cancers that originally respond to treatment with standard hormone therapy become resistant over time, resulting in castrate-resistant prostate cancer . Three new drugs have been shown to extend survival in men with CRPC. All three block the action of hormones that drive CRPC:

The survival benefit for these drugs has been seen regardless of whether men have previously received chemotherapy.

In addition, both enzalutamide and the drug apalutamide have all been shown to in men with CRPC that has not yet spread to other parts of the body. Darolutamide has been shown to increase the amount of time men live without their cancer metastasizing.

Abiraterone, apalutamide, and enzalutamide have been shown to improve the survival of men with metastatic castrate-sensitive prostate cancer when added to standard hormone therapy.

Scientists are continuing to study novel treatments and drugs, along with new combinations of existing treatments, in men with metastatic CRPC.

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Immunotherapy: Vaccines For Prostate Cancer

Immunotherapies are treatments that harness the power of the immune system to fight cancer. These treatments can either help the immune system attack the cancer directly or stimulate the immune system in a more general way.

Vaccines and checkpoint inhibitors are two types of immunotherapy being tested in prostate cancer. Treatment vaccines are injections that stimulate the immune system to recognize and attack a tumor.

One type of treatment vaccine called sipuleucel-T is approved for men with few or no symptoms from metastatic CRPC.

Diet And Exercise Interventions Among Men With Prostate Cancer

PD

open to eligible males ages 18 years and up

The Prostate 8-II study is a 2-year randomized controlled trial of testing different combinations of educational and supportive tools related to diet and exercise to evaluate biological, clinical, and quality of life outcomes in men choosing radical prostatectomy as treatment for prostate cancer.

San Francisco, California

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Advances In Prostate Cancer Research

Nanoparticles are tested as a means to deliver drugs to prostate cancer cells.

NCI-funded researchers are working to advance our understanding of how to prevent, detect, and treat prostate cancer. Most men diagnosed with prostate cancer will live a long time, but challenges remain in choosing the best treatments for individuals at all stages of the disease.

This page highlights some of the latest research in prostate cancer, including clinical advances that may soon translate into improved care, NCI-supported programs that are fueling progress, and research findings from recent studies.

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