Men with untreatable prostate cancer could live longer

‘Lazarus’ drug pulling men with lethal prostate cancer back from the brink through pioneering immunotherapy treatment

  • Trial in London showed positive results when men used the drug pembrolizumab
  • It is first time immunotherapy shown to benefit some men with prostate cancer
  • Immunotherapy drugs stimulate immune system to recognise and fight cancer 

Scores of men with the most lethal form of prostate cancer have been ‘brought back from the brink of death’ by a drug found to work where all others have failed in a groundbreaking British-led trial.

Some patients whose bodies were riddled with cancer have had ‘Lazarus-like’ recoveries – and now show no visible signs of disease 18 months or more later, according to the doctor leading research into the treatment.

The medication, called pembrolizumab, is a type of immunotherapy that harnesses the body’s immune system to seek out and destroy tumour cells. It has already been shown to be highly effective in tackling other forms of the disease, including skin and lung cancer.

Scores of men with the most lethal form of prostate cancer have been ‘brought back from the brink of death’ by a drug found to work where all others have failed in a groundbreaking British-led trial

Now, a new study led by The Institute of Cancer Research and the Royal Marsden Hospital in London has found ‘amazing’ results in those with prostate cancer.

The disease is the most common form of male cancer: one in eight will be diagnosed with it during their lifetime. There are 47,000 new prostate cancer diagnoses annually in the UK alone, resulting in 11,000 deaths a year.

The trial looked at 258 men who had undergone numerous other treatments, including surgery, hormonal drugs and chemotherapy, to no avail. In many of them, the cancer had spread to their bones, usually a sign there is no more hope.

Men with otherwise untreatable prostate cancer could halt its spread and survive longer by undergoing immunotherapy treatment, a major trial in London has shown

But according to results being presented in detail tomorrow at the annual meeting of the American Society of Clinical Oncology (ASCO) in Chicago, more than a third of those treated with pembrolizumab were still alive after a year. And one in ten were still actively benefiting from treatment.

Researchers found those with the best response had types of prostate cancer with ‘ultra-mutant cancer cells’ which change their genetic make-up quickly. Among these types are those linked to the BRCA gene, the mutation carried by actress Angelina Jolie, which is best known for raising the risk of breast and ovarian cancer.

The results will bring hope to men such as BBC presenter Bill Turnbull, 62, who in March revealed that he had been diagnosed with prostate cancer which had spread ‘to the bone’. Last month he told how he had ‘just had six rounds of chemo’ and was expecting to undergo more.

World-leading prostate cancer expert Professor Johann de Bono, of the Institute for Cancer Research, said: ‘We hope for a cure but we can’t call it that yet. However, many of the men who were at death’s door have been on the drug for more than 18 months and show no signs of the disease.’

Such patients had experienced ‘an amazing response’, he said. ‘Some of the patients on this trial are like Lazarus – they were dying of advanced disease. Some were almost too unwell to have any treatment at all and they have been resurrected.’

Pembrolizumab, also known by its brand name Keytruda, is one of a new class of drugs called ‘checkpoint inhibitors’.

Prof de Bono said the drug was ‘well tolerated’ by patients ‘with relatively few severe side effects’. He added: ‘The next stage is to try and develop tests to help us better identify which patients will benefit most.’

Prostate expert Dr David Graham at Levine Cancer Institute, North Carolina, said: ‘These men have the most aggressive type of disease and have been through the gamut of what we have available now. These findings show the glimmer of promise for them.’

Further trials will be needed before the drug, already licensed for certain types of skin cancer, lung cancer and lymphoma, is approved for routine clinical use in prostate cancer. It will then have to be assessed by the National Institute for Health and Care Excellence to see if it is cost-effective enough for prostate NHS cancer patients to receive it.

Former BBC presenter Bill Turnbull, who revealed in March he had been diagnosed with prostate cancer

That is not a given, as a course of treatment in other cancers typically costs tens of thousands of pounds per patient.

The news comes as a major new study reveals that a simple blood test carried out in the GP’s surgery could detect up to half of deadly lung cancers in the earliest stages.

Experts say the findings should pave the way for routine screening for heavy smokers and others at high risk of lung cancer.

Despite falling smoking rates, lung cancer is still Britain’s biggest cancer killer, claiming 35,000 lives every year.

But now results from the ongoing Circulating Cell-Free Genome Atlas study, also presented at ASCO, offer hope of much earlier diagnosis – and so better survival. Researchers looked at the ability of three different blood tests looking for free-floating DNA to detect cancer.

The tests picked up almost 90 per cent of late-stage cancers. More excitingly, it identified up to 50 per cent of early-stage tumours too.

Professor Geoffrey Oxnard, of the Dana-Farber Cancer Institute in the US, said: ‘The beauty of a blood test is it could just be done in a local GP office.’

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