A piece in today’s Times:
Four thousand men a year could soon benefit from a revolutionary treatment that freezes prostate cancer in its tracks.
In a landmark trial, olaparib, one of a new wave of drugs that target specific weaknesses in a patient’s tumour, held the disease at bay for more than twice as long as existing treatments.
The men also spent less time in pain and may have lived longer overall, the European Society for Medical Oncology’s annual conference was told.
Experts said that the result could “revolutionise” prostate cancer treatment by opening up a new era of precision medicine in which men will be given drugs tailored to their tumours.
It is thought that about a third of men with advanced prostate cancer, some 4,000 a year, could be suitable and the drug could be in widespread use in as little as two years.
Professor Johann de Bono, of the Institute of Cancer Research (ICR) and the Royal Marsden Hospital in London, the trial’s co-leader, said: “This study is a powerful demonstration of the potential of precision medicine to transform the landscape for patients with the commonest of male cancers.
“I hope that within the next couple of years olaparib will become the first precision medicine to become available as a standard treatment for men with prostate cancer.”
Dr Matthew Hobbs, of the charity Prostate Cancer UK, said: “This hugely exciting result represents a revolution in the treatment of prostate cancer. It finally brings prostate cancer medicine into the 21st century by giving us, for the first time ever, a therapy that makes use of genetic testing of the tumour to work out which men will benefit.
“This kind of precision medicine approach is already used to treat other cancers, and we hope olaparib will become the first of many treatments for prostate cancer which are based on this sort of detailed understanding of an individual man’s tumour.”
Precision medicines, drugs that exploit particular genetic flaws in a patient’s tumour, have led to great advances in the treatment of breast and ovarian cancer in recent years but prostate cancer has lagged behind until now. It is the most common cancer in men, with 48,000 cases a year and 11,500 deaths.
While the new treatment is not a cure, it could give patients in the late stages of the disease extra time with their families as well as a better quality of life.
Some 387 men with advanced prostate cancer were either given olaparib, a pill that is already used to treat breast and ovarian cancers, or existing drugs including abiraterone, which a decade ago was described as the biggest breakthrough in the field for 60 years.
In those taking olaparib, the disease was held at bay for an average of 7.4 months, compared with the 3.6 months before the cancer started to grow and spread again in the other men.
It is too early to know for certain whether the men on olaparib lived longer overall but preliminary results suggest that the drug gave them an extra three and a half months on average. Those on olaparib did experience more side-effects, however.
Olaparib exploits a genetic weakness in some cancers to stop them repairing their damaged DNA. This kills the cells, while sparing healthy ones.
All of the men in the study, which was funded by the drug company Astrazeneca, had tumours with genetic defects that were a match to the drug.
Prostate Cancer UK called for all men with advanced prostate cancer to have their tumour tissue tested to see if they could benefit from olaparib once other treatments are no longer working.
Professor Paul Workman, ICR chief executive, said: “Olaparib has already improved and extended the lives of women with ovarian and breast cancer and it’s hugely positive to now see the results of this trial paving the way for olaparib to become an innovative new treatment for prostate cancer.”
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