BC Cancer continues to lead clinical trial research

Prostate cancer is the most common cancer among Canadian men. And while initial treatments are usually successful and five-year survival rates are relatively high, more effective solutions are needed for patients with aggressive sub-types of the disease.

When prostate cancer recurs, physicians are often unable to precisely identify where the new disease is located. This leaves two treatment options: therapies that target the whole prostate, or androgen deprivation therapy that reduces the level of androgen hormones (such as testosterone), which prostate cancer cells use to grow.

BC Cancer is home to a diverse team of highly skilled specialists, including medical oncologist Dr. Kim Chi, head of the Genitourinary Tumour Group and medical director of the Clinical Trials Unit, and nuclear medicine physician Dr. François Bénard, vice-president of research at BC Cancer and scientific director at the Centre of Excellence for Functional Cancer Imaging.

In less than two decades, Dr. Chi has become a leading expert in prostate cancer research, receiving international recognition for his contributions to the field. Dr. Bénard, an expert in medical imaging and radiopharmaceutical development, made headlines in 2015 when he and his colleagues at UBC devised a safer, cleaner, less expensive source of medical isotopes.

Donor support has enabled researchers to continue accelerating clinically relevant discoveries.

Part of Dr. Kim Chi’s focus of research is developing novel approaches for the treatment of metastatic castration-resistant prostate cancer (m-CRPC). This is a type of prostate cancer that has spread and is not responding to drug and other treatments used to lower androgen hormones.

Over the past two years, Dr. Chi has published more than 45 research papers in peer-reviewed journals. He discovered that cancer-derived DNA can be found in the blood of men with m-CRPC, and can be isolated and sequenced to reveal important information about their cancer. This information has the potential to determine prognosis and guide treatment decisions.

Dr Kim Chi, BC Cancer

 

“Being able to communicate our research vision, where we need to be and what we can do to get there, and then have someone have the belief and commitment to invest in that future, is extremely inspiring and motivating. It makes it very personal for me.”

– Dr. Kim Chi

Read more in Dr. Chi's guest blog

 

Harnessing the power of protein-targeted therapy

The recent discovery of a protein on the surface of prostate cancer cells suggests there may be a better way to treat advanced cases of the disease. By targeting this prostate specific membrane antigen (or PSMA) with tiny radioactive probes, a potent treatment can be delivered to the exact location of the cancer with minimal side effects to surrounding tissue.

Results from a recent German study investigating the effectiveness of protein-targeted therapy involving radioisotopes showed a positive result in 45 per cent of participants.

The findings, published in The Journal of Nuclear Medicine in January 2017, suggest that patients treated with 177Lu-PSMA-617 (a drug treatment paired with a specific radioisotope) has the potential to change the future of prostate cancer treatment for metastatic patients, safely and effectively with minimal side effects.

Prostate cancer patients in the study who were treated with the radioisotope Lu coupled with PSMA-617 showed a remarkable response: 75 per cent of patients who were given two to four months to live were not only alive six months after receiving the treatment, their tumours had shrunk and they had lower levels of PSMA in their blood.

More promising reports also focused on two patients treated with the same drug but tagged with a more potent radioisotope. After receiving the treatment, called 225Ac-PSMA-617, the cancer, which had been unresponsive to standard therapies (including surgery, radiation therapy, hormone therapy and chemotherapy), could no longer be detected by PET/CT imaging or blood tests.

Although the German results are promising, they haven’t pushed the concept far enough. This is where BC Cancer comes in. Proving the effectiveness of 177Lu-PSMA-617-based treatments via clinical trials will be a game-changing first step.

Trials set to trace next level of promising treatment

Experts at BC Cancer are ready to launch two Prostate Tracer (ProTracer) clinical trials that will harness the power of radiopharmaceuticals and scientifically confirm the effectiveness of 177Lu-PSMA-617 in treating metastatic prostate cancer.

Set to launch in January 2018, these rigorous, evidence-based studies will involve the next phases of testing with 177Lu-PSMA-617, and will involve patients with metastatic prostate cancer that has continued to progress after treatment. The studies will provide crucial data about the effectiveness of radiopharmaceutical-based treatments with an aim to deliver actionable results.

Donors also continue to support prostate cancer research on other fronts. Dr. Marianne Sadar’s EPI-506 drug entered phase I/II of human clinical trials at BC Cancer and sites across North America in 2015. The drug is specifically designed to target and shut down m-CRPC (metastatic castration-resistant prostate cancer) when other treatments have failed.

To date, seven patients have been enrolled in the first phase of the trial. Trial lead Dr. Kim Chi and his colleagues are trying to find the best dose to shrink tumours, and he expects the team will know the maximum tolerated dose later this year, as well as new data on PSA (prostate-specific antigen) levels and the effect of the drug on the tumours.

If Phase I of the trial continues as anticipated, Phase II (involving 150 patients at 20 sites) could begin later this year, followed by Phase III. The entire clinical trial process is expected to last approximately five years.

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