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New developments
in Prostate Cancer
Dr Jo Bowen
Consultant Oncologist
Worcestershire Royal Hospital
Key areas of Prostate
cancer research:
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Making the diagnosis
Improving outcomes of radical
treatment
New treatments for patients with
advanced disease
Prostate Cancer
diagnosis:
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Diagnosis of prostate cancer is made by
carrying out a prostate biopsy
This is usually carried out because:
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the patient has new suspicious
symptoms
the prostate feels abnormal
PSA blood test is raised
Prostate Cancer
diagnosis:
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PSA sensitivity is low when the levels
are only slightly raised
Only one in five biopsies will show
cancer in this situation
Research is ongoing looking for more
accurate ways of predicting the
presence of cancer
Urine PCA 3 test: prostate
cancer diagnosis
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New urine test looking at the amount of a
prostate cancer gene product in the urine
The greater the amount, the higher the
chance of prostate cancer being present
May become a useful additional test when
deciding on initial or repeat biopsies
Radical Radiotherapy for
prostate cancer
•
Aims of
research in
radiotherapy:
• Improve
effectiveness
• Reduce side
effects
Improving Effectiveness:
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Increasing dose
Changing daily dose/ length of
treatment
Addition of other treatment modalities
New hormone treatments
Chemotherapy
Targeted agents
Reducing side effects
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Reducing dose to nearby organs:
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- Intensity modulated radiotherapy
(IMRT)
- Increasing accuracy of patient
positioning
New treatments for
advanced prostate cancer
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The majority of prostate cancers are
stimulated by the male hormone testosterone
Mainstay of treatment for advanced prostate
cancer is removing this stimulus usually by
suppressing the production of testosterone
Advanced prostate cancer
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In time the prostate cancer can start to
progress without the stimulation of male
hormones
Chemotherapy is effective in improving
quality and length of life
Urgent need for effective treaments at this
stage
Process of new drug
development:
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Laboratory development - drug companies
Small trials primarily to look for side effects
Studies to look for activity against the cancer
Much larger ‘randomised’ studies to confirm
expected effectiveness and side effects
Hormone therapy:
Abiraterone
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New drug that prevents the synthesis of male hormones
Current studies have looked at patients who have already had
chemotherapy and the results are encouraging
Larger trials have now completed recruiting patients and the
results are awaited
Studies are also looking to see if this drug can improve the
effectivness of radiotherapy
Chemotherapy:
Cabazitaxel
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New chemotherapy drug
Recent large trial has shown activity in
patients who have already had standard
chemotherapy with improved response
rates and survival
Targeted agents:
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Bevacuzimab
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Antibody that inhibits the blood
supply to the tumour
Ipilimumab (MDX-010)
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Antibody that stimulates the
immune system to fight the cancer
cells