We have many new drugs that have been recently approved to treat advanced prostate cancer. Two of these drugs are abiraterone (Zytiga) and enzalutamide (Xtandi).

These drugs offer new hope to men with advanced prostate cancer after the cancer has become resistant to hormone therapies (called “castration-resistant prostate cancer”).

These drugs are a real breakthrough, however about 20% of men prescribed these drugs do not respond to these drugs (i.e. PSA does not go down, tumors do not shrink). Currently we don’t know why some men respond to these drugs, while others are resistant.

Knowing in advanced if a man will respond is important. It is important because:

1- We could realize significant economic savings by not giving them to men with advanced prostate cancer who will not respond these drugs. Given that these drugs cost between $5,000 and $7,500 per month we could stop wasting the drugs and save the money.

2- If we give a man who does not respond to the drug we are also allowing his prostate cancer to continue to grow, or progress. This means that when we move a non-responder to a new drug his disease will be more serious and harder to battle.

A lab at John’s Hopkins University has discovered a clue that might help to solve the dilemma of knowing if a man will respond prior to treatment. They have studied prostate cancer cells from the bloodstream of men with advanced prostate cancer. These cells are called circulating tumor cells (CTCs).

By using these CTCs, they are able to analyze the genetic material from these cells (the DNA) to find out if they can predict ahead of time which men will respond.

This lab proposes to test out this theory by collecting CTC samples from men being treated with Zytiga or Xtandi at 3 different time points: just prior to starting therapy, at the time of a clinical response to therapy, and at the time of resistance to therapy. In this way, they will be able to investigate whether certain mutations in the DNA of the cancer cells may help explain who will be resistant to these agents and who will respond to these drugs.
This information would be useful when making decisions about treatment options for men with castration-resistant prostate cancer. Very importantly, this project will be able to generate a lot of information about a patient’s prostate cancer by using a non-invasive “liquid biopsy” without ever requiring a needle biopsy (which can be painful and also has other risks).

Ultimately, it is hoped that a better understanding of the genetics of each patient’s cancer cells may lead to better decision making and also other novel therapies to target each particular patient’s cancer in a more personalized manner.

This project is being proposed by Emmanuel S Antonarakis, M.D., and
Jun Luo, PhD of Johns Hopkins University.

To learn more about this project and many others outstanding projects go to www.StartACure.com and make a pledge to support this important research project.

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Joel T Nowak, M.A., M.S.W.