New Cancer Treatments Give Hope to Men With Prostate Cancer

Prostate cancer treatment took a major step forward recently with promising new treatments for men with aggressive forms of the cancer. Prostate cancer is the most common form of cancer, behind skin cancer, among men in America, with one in eight men diagnosed in the U.S. each year.

Certain types of prostate cancers grow slowly while others are aggressive and spread quickly. Common treatment options include drug therapies that block the male hormones (anti-androgen) that feed tumor growth. However, cancer cells often mutate and evade common hormone-based treatments, becoming resistant over time and resulting in castrate-resistant prostate cancer (CRPC). CRPC is prostate cancer that grows regardless of the amount of testosterone or male hormones in the body and has spread to other parts of the body including the lymph nodes and bones.

Four new FDA-approved drugs are showing promise in treating CPRC -- Abiraterone acetate (Zytiga), apalutamide (Erleada), darolutamide (Nubeqa) and enzalutamide (Xtandi). They’ve been found to extend the survival rates in some men that have become resistant to the anti0androgen therapies and can also be used in those whose prostate cancer still responds to standard hormone therapies, but whose cancer has spread or metastasized to other parts of the body.

Scientists continue to study treatment options, as well as new drug combinations in men with metastatic and CPRC. Researchers from Pfizer have recently developed a combination therapy for metastatic CRPC that combines two existing medications, enzalutamide (Xtandi) and talazoparib (Talzenna) that has completed phase 3 drug trials as TALAPRO-2. This therapy works by combining the testosterone-blocking drug enzalutamide to the drug talazoparib, which is a PARP inhibitor. PARP inhibitors are used in cancer treatments to block the repair function of PARP in active cancer cells, causing them to die.

Another area of promise comes from researchers at UC Davis Health who have developed the LX-1 molecule that simultaneously targets androgen receptors, the genes responsible for regulating male hormones and the AKR1C3 enzyme (regulates active hormone productions) which are both known to drive resistance to hormone-based treatments. The LX-1 molecule blocks testosterone production which prohibits tumor growth and can be used alone or in combination with other anti-androgen therapies more effective.

While there is much work being done in the study and prevention of prostate cancer, it’s important to know the signs and symptoms to look out for. Early forms of prostate cancer can go unnoticed due to the lack of symptoms, so routine exams are important. The most common symptoms that are typically found in later stages of the disease can include blood in the urine or semen, frequent or painful urination, a weak or interrupted urine flow, pain in the lower back, hips or upper thighs, and erectile dysfunction.

A simple blood test called a prostate-specific antigen (PSA) test can administered by your healthcare provider. It is used to determine the presence of normal and abnormal proteins made by cells in the prostate gland. The amount of PAS present in the bloodstream can fluctuate with levels being highest with cancer.

The American Cancer Society suggests that all men begin prostate cancer screenings by age 50 following these guidelines:

• Age 50 for those with an average risk of prostate cancer
• Age 45 for those with a high risk of prostate cancer. High risk is defined as being African American or if you have an immediate family member that has been diagnosed with prostate cancer under and is under 65 years of age.
• Age 40 for those men with a very high risk of prostate cancer due to multiple immediate relatives diagnosed with prostate cancer before the age of 65.

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Daniel LaVie, MD
Hematology Oncology
Mary Bird Perkins Cancer Center
(225) 215-0800