Dr Matthew Hobbs is “doubly excited” by new precision medicines for advanced prostate cancer.

We've just seen very exciting results from research into two new precision treatments for advanced prostate cancer.

Our Director of Research, Dr Matthew Hobbs, joined scientists around the world at The European Society for Medical Oncology (ESMO) virtual conference on Sunday. Here Matthew explains the history of precision medicine for prostate cancer, what these results mean for men, and how people like you make this progress happen.

What is precision medicine?

Precision medicine can treat men based on the specific genetic characteristics of their prostate cancer. It means moving away from the one-size-fits all treatment approach that leaves some men responding well for many years, while others see little to no benefit. Ultimately, it will help men live longer and better with prostate cancer.

Precision medicine is already common practice in many diseases, like breast cancer and lung cancer, but has lagged behind in prostate cancer.

That’s something we’ve been working to change for a long time. Especially since 2017, when we funded our two major precision medicine programmes with help from Movember. We aimed to give men access to the new, targeted treatments they desperately need within the next decade. Our goal was to see the first precision medicine available by the end of 2020 with further precision medicines in phase III trials.

Our first success: Olaparib

Thanks to research supported by you, we’re now tantalisingly close to making the first precision medicine, olaparib, available for men. Last year, olaparib was proven to slow the growth and spread of prostate cancer in men with certain genetic mutations in their cancer.

Back in 2014, Prostate Cancer UK and Movember funded research that showed which prostate cancers might respond to olaparib, paving the way for the large clinical trial that has now proven that this drug can extend the lives of men who have faulty DNA repair genes.

New results released this weekend have confirmed it could help those men with advanced prostate cancer to live a further 4.4 months. I’m hopeful we’ll see olaparib move through the drug approval process to become available to the men who need it by early next year.

Ipatasertib: 25 years in the making

Now there’s a second precision medicine hot on olaparib’s heels, and we're not just in Phase III trials, we're seeing the first results from that trial. Ipatasertib works in a completely different group of men to olaparib, in those missing a specific gene called PTEN. Results from the trial  show it does this effectively – enough to stop men’s prostate cancer progressing for 2 months compared to current treatments. This means it's likely that if we can use more accurate ways to find the men with cancers that are likely to respond, we should be able to get even better results from this drug.

Over our 25 years as a charity, we’ve funded dozens of research projects studying PTEN. Between 40-50 per cent of men with prostate cancer potentially have cancer that is missing the PTEN gene, so we knew it had big potential to impact men’s lives. In 2008, ground-breaking results proved us right. Our researchers showed that men with prostate cancer missing the PTEN gene had significantly worse outcomes from their prostate cancer than other men.

This insight ignited a new wave of research into the PTEN gene, to find out how we can treat these men with some of the most aggressive forms of the disease. The results are now credited as some of the most significant in this area by one of the scientists who worked on that research, and the leader of the phase III ipatasertib trial, Professor Johann de Bono. He told us, “The results published in 2010 were the first time anyone had proven how much this common genetic change could influence men’s prostate cancer, and showed how important it would be to pursue new understanding and treatments in this area.”

Your funding has allowed Professor de Bono, along with many others, to investigate treatments for PTEN-deficient men. We’ve funded a further four research projects worth over £2 million with Professor de Bono to continue his study of PTEN.

He said, “Prostate Cancer UK’s support has been tremendously important in uncovering the complex role of PTEN and the impact it could have on treating men with the most aggressive prostate cancers."

Our first successes in a precision treatment revolution

Olaparib and ipatasertib signal the beginning of a revolution in prostate cancer treatment – one that finally works in a targeted, specified way to give men the most benefit possible.

We're funding another four research projects looking at treatments for men missing the PTEN gene. One led by Dr Chris Armstrong at the University of Belfast, has already shown the importance of PTEN loss on treating men with localised prostate cancer. He’s shown they’re more likely to become resistant to radiotherapy. Understanding the impact of PTEN loss could help us give these men a different treatment, or even better, give them drugs that specifically target the PTEN pathway and make radiotherapy more likely to cure them first time round.

I can’t wait to see results from projects like these. Our precision medicine programmes continue to deliver results for men with prostate cancer, and I’m confident this is just the beginning of a revolution in treatment that will transform the lives of thousands of dads, brothers, sons and friends affected by prostate cancer. Thank you so much.

Thank you for making this progress in precision medicine possible. Donate now to keep up momentum, and help men live longer and better with prostate cancer.