A new approach to prostate cancer treatment?

(uplifting music) – In order to beat your enemy you’ve got to understand it. And this is really where the excitement is nowadays is we are getting closer and closer to better understanding the enemy, which is the cancer. – Prostate cancer is a very common disease in the United States. The American Cancer Society really estimates in 2012 that over 240,000 men will be diagnosed with prostate cancer in the US. – [Maha] One is six men could actually end up with prostate cancer, which means it could be one of my relatives, it could be one of my neighbors.
It’s the most common cancer diagnosis in American men. – One of the conventional treatments for prostate cancer is called hormonal treatment, and in general what this does is it slows down the growth of prostate cancer. – Now one of the things about prostate cancer, and in fact all cancers, is that the cancer cells become smarter and smarter.
The more they get injured or subjected to different treatments, the smarter they become. – [Arul] Once prostate cancer has spread or metastasized, it becomes very difficult to control, and oftentimes hormonal treatment does not work. – It’s when the cancer begins to become resistant to the hormone treatment is when the patients will end up dying from that disease.
So it’s still a disease that requires new, innovative treatments. – For a long time we didn’t have a good understanding on how it functions on the inside. So as we infiltrate the cancer, so to speak, to try to dissect it at a very molecular level, we are getting better and better understanding of what really makes that cancer cell eternal. What makes it come back, what makes it live, what makes it die.
One of our most exciting discoveries was the discovery that over 50% of prostate cancers actually harbor a gene fusion, a gene that’s normally turned on by hormones gets fused upstream of a gene that controls cell growth and basically that leads to turning on that particular gene that leads to cell growth, essentially leading to cancer. This fusion of two different genes that shouldn’t be together, creating this hybrid gene, essentially is then a hallmark of cancer in general.
In this particular clinical trial we’ve identified a drug that actually hits an enzyme that directly interacts with the gene fusion, and that enzyme called PARP is actually required for the gene fusion to cause cancer.
By blocking the PARP enzyme, you’re essentially indirectly blocking the cancer-causing ability of the gene fusion. – And that knowledge is what we’re trying to translate to patients. Without patients, you have no proof. The partnership and the volunteering of patients is absolutely the most critical factor for the completion of this particular study.
We really need patients to participate in this trial in order for us to better understand prostate cancer, to identify why certain patients respond to certain therapies while others do not. – Key elements for eligibility is that men have to have metastatic cancer that is castration resistant, which means progressed on hormone treatment
A critical factor is that the men have to be willing to undergo a biopsy of metastatic area, which means a biopsy of a bone or a lymph node or a liver or lung, if in fact there is cancer in those areas. The biopsy must have tumor in it because a critical factor is assessing their cancer for the presence of the gene fusion, whether it’s present or absent.
The patients are then assigned one of two treatment groups. Half of them will get the drug Abiraterone, which is a standard drug, and the other half of the patients will end up getting Abiraterone plus another drug called ABT 888. This particular drug targets the repair enzymes that the cancer cells have in order to arm themselves to continue to grow, so in essence, everybody gets treatment, everybody gets the standard treatment, and half of the patients will end up getting the experimental drug added to the standard drug. – What this will really allow us to do is to see if patients that have the gene fusion behave differently to drugs than those that don’t have the gene fusions.
So if it works, it actually means that we are going to be able to better control and better treat the cancer. This particular clinical trial and this particular scientific effort represents, I think, one of the best-case scenarios of team science, team research, where the idea and its application has started at the University of Michigan. There are a lot of smart people out there and we’ve partnered with them. 11 other comprehensive cancer centers nationwide have elected to be part of this particular clinical trial.
We’ve actually been able to procure support from the Standup to Cancer Foundation, as well as the Prostate Cancer Foundation in support of the comprehensive sequencing of the biopsies that will be obtained from the patients that enroll on this particular trial. – [Maha] Everyone is focused on conquering cancer to save lives, reduce suffering, reduce pain, and hopefully cure cancer.
That’s our ultimate goal. – By better understanding the cause of prostate cancer, we’re very excited because now we potentially have the ability to develop therapies that actually go after the cause of the disease. – If the treatment really works well, then hopefully the pain and suffering that happens with the disease may not happen for that particular patient, or if it’s going to happen, it’s gonna be delayed.
But there is also the big picture, and a lot of my patients actually understand and in fact they voice it, they say, it may not help me but it may help people in other places or my children or grandchildren. So there’s the sort of wanting to help and save the world, so to speak, attitude that patients have. That keeps us going, and that’s really why I am very passionate about not just taking care of patients, but also clinical research and research in general, because I do believe that research is what will cure cancer. Everyday there is progress and it is possible.
It is possible to make a difference for patients. It is possible to make them live longer. It is possible to reduce their pain and suffering. And we have cured some other cancers and I am convinced, it may not be in my lifetime, but I hope in my lifetime that we can make a huge difference in prostate cancer, and in fact, we’re already seeing that happen. If you in fact have advanced prostate cancer, and if you want to try a newer treatment, and if you wanna partner with us to make a difference we would love to take care of you. (uplifting music)