A piece in today’s Times:
Scientists have hailed a “real breakthrough” and a “new era” in treating prostate cancer after trials showed that two drugs can hold the disease at bay and extend the lives of patients.
Experts have said that the findings open the way for a drug called olaparib, originally designed to treat breast and ovarian cancers, to gain approval for use in Britain and become the standard treatment for men with certain forms of advanced prostate cancer.
It is the first cancer drug that targets a specific genetic fault and can be used to treat prostate cancers where the damaged DNA cannot be repaired.
A final-stage trial found that olaparib extends the average survival time for men with these forms of prostate cancer by up to four and a half months compared with the best hormone treatments already available.
A separate trial, at an earlier stage, has found that another drug called ipatasertib can also lead to a “significant reduction in the risk of the disease worsening or death”.
Matthew Hobbs, director of research at Prostate Cancer UK, said: “These results represent a real breakthrough for men with advanced prostate cancer. Olaparib and ipatasertib mark a new era for treatment, one based on a detailed understanding of each man’s cancer rather than a ‘one size fits all’ approach.
“Precision medicines like these hold enormous potential and could radically reduce the number of men dying from prostate cancer.”
More than 11,500 men die from prostate cancer each year in Britain with about 50,000 cases diagnosed per year, making it the most common cancer.
The olaparib trial, called PROfound, studied 387 men with advanced prostate cancer who had faults in the genes that help to repair faulty DNA.
It found that men with faults in their BRCA1, BRCA2 or ATM genes had an average survival time of 19.1 months when taking olaparib, compared with 14.7 months for those on hormone treatments.
For patients with faults in other DNA-repairing genes, median survival time was 14.1 months, compared with 11.5 months for those on hormone treatments.
Johann de Bono, a professor of experimental cancer medicine at the Institute of Cancer Research (ICR) and co-author of the study, which was published in The New England Journal of Medicine, said: “I’m confident that our results will transform prostate cancer treatment — hopefully very soon.”
An ICR spokeswoman said that the findings “pave the way for regulatory approval of olaparib in prostate cancer in Europe and in the UK”.
The National Institute for Health and Care Excellence is to meet in November to discuss the use of the drug, with a report expected in February.
A report from the trial into ipatasertib, published by the pharmaceutical company Roche, said that trials would have to progress further before a figure could be put on the “overall survival benefit” from the drug.
Olaparib is a type of drug called a “Parp inhibitor”. Parp, which stands for poly-ADP ribose polymerase, is a type of enzyme that helps damaged cells to repair themselves. If a drug inhibits the function of these enzymes within cancer cells, they die.
The drug has been approved by the US Food and Drug Administration based on an earlier stage of the trial.
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