Research round up from the clinic - top five articles from May 2015:
1. Earlier chemotherapy treatment can keep men with advanced prostate cancer alive for longer
A press release from the UK-led trial STAMPEDE trial was recently published ahead of a presentation of the results at ASCO’s annual meeting in June 2015. The STAMPEDE trial found that adding docetaxel chemotherapy to standard hormone therapy markedly improves survival for men with newly diagnosed advanced prostate cancer not previously treated with hormone therapy (hormone-naïve). Men who received docetaxel plus standard therapy lived on average ten months longer than those who received only standard therapy. Director of Research, Dr Iain Frame, said: “The findings of this trial are potentially game-changing – we can’t wait to see the full results at ASCO.” Read Prostate Cancer UK’s comment on the preliminary results from the STAMPEDE trial here. We’ve tried to address some of the key questions the research has raised for men with prostate cancer have been answered here.
2. Prostate cancer gene map could help targeted drugs
Robinson and his colleagues conducted a prospective study, sequencing the genetic codes of bone, soft tissues, lymph nodes and liver from 150 patients with metastatic prostate cancer. The scientists, based in the UK and US, used this information to create a comprehensive map of the genetic mutations within lethal prostate cancers that have spread around the body. The study revealed that almost 90% of men with advanced prostate cancer carry genetic mutations in their tumours that could be targeted by either existing or new cancer drugs. Nearly two thirds of men in the study had mutations in a molecule that interacts with the male hormone androgen which is targeted by current standard treatments. Mutations in the BRCA1 and BRCA2 genes, often know for their roles in breast cancer, were found in nearly 20% of patients. The scientists also reported new mutations, previously never detected in prostate cancer, but which do occur in other cancers. Almost 90 per cent of men with advanced prostate cancer carry genetic mutations in their tumours that could be targeted by either existing or new cancer drugs. The study also reported some evidence which may strengthen the case for genetic screening for people with a family history of the disease. The scientists believe the results of this study provide evidence that clinical sequencing in advanced prostate cancer is feasible and could impact treatment decisions in significant numbers or patients. In response to the publication of this exciting and ground-breaking research Dr Iain Frame, Director of Research at Prostate Cancer UK said: “This could provide the information about the best routes of attack in each individual case, which is crucial if we are to reduce the number of men dying needlessly from this disease. What’s more, many of the genetic changes they have identified could potentially be targeted by existing drugs.” More information and news on the study results can be found on the Institute of Cancer Research website (here).
3. Can statins slow the progress of prostate cancer?
Researchers from Boston, Harshman et al., investigated the effects of statins in men being treated with hormone therapy. The researchers looked at the clinical records of 926 men whose prostate cancer had either returned after treatment, or who had been diagnosed with prostate cancer that had already started to spread. Almost one third of those men were already taking some form of statin at the time that they initiated hormone therapy. The results also showed that it took longer for the cancer to progress in men who were taking statins at the same time as hormone therapy than in those who weren’t. Dr Iain Frame, Director of Research at Prostate Cancer UK said: “Whilst we continue to explore why men’s cancers stop responding to hormone therapies, this study suggests that taking statins alongside established treatments could be an effective and affordable way to extend the time that they can keep the cancer in check.” Read Prostate Cancer UK's comment on the research here.
4. Benefits of exercise for prostate cancer survivors
Phillips and colleagues from the United States assessed the relationships between types and intensities of activity and sedentary behaviour and the quality of life of almost 2,000 men diagnosed with non-metastatic prostate cancer. After controlling for potential confounders (e.g. pre-diagnosis physical activity and sedentary time) the researchers reported findings indicating higher duration of total, non-vigorous activity and walking, were associated with better hormone/vitality functioning (e.g. hot flushes, depression and changes in body weight). It was also noted that the data suggests engaging in just 90 min of normal/brisk walking per week may provide some benefits. The relationship between activity and hormone/vitality function appeared to be even stronger in longer-term survivors, and those who have chronic conditions and were diagnosed with more advanced disease indicating that targeting programmes and treatments at these groups may be particularly beneficial for improving prostate cancer-specific health-related quality of life.
5. Obesity link to prostate cancer may vary by race
In this prospective study, Barrington and colleagues investigated whether the association between obesity and prostate cancer risk differs by race. Data from over 3,000 African-American and more than 22,000 non-Hispanic white men were analysed. The reported body mass index (BMI) was positively associated with prostate cancer risk among African-American men, but there was no association of BMI and risk among non-Hispanic white men. African-American men considered to be severely obese (>35 kg/m2) were twice as likely (103% or a hazard ratio of 2.03) to be diagnosed with prostate cancer, compared to non-Hispanic white men. The study also looked at the association of body mass and race on the grading of prostate cancer (e.g. Gleason score). The researchers identified the need to understand the mechanisms underpinning the associations, although they also suggest that reducing obesity among African-American men could reduce the racial disparity in cancer incidence.