Health: Drug trial hope for men with prostate cancer

Research at early stage but doctors say treatment may be major advance

A new drug to fight the deadliest forms of prostate cancer could put thousands of men into remission, allowing them to work and travel as before and potentially save lives, the head of a worldwide clinical trial has announced.

Dr Johann de Bono, lead researcher of trials that began at the Royal Marsden Hospital, London, said the treatment is "spectacularly active ... we believe we have made a major step forward in treating patients who have failed all other treatments".

Trials of the drug, abiraterone, are still at an early stage and no patient has taken it for longer than two and a half years. However, results have been very promising and there is hope it may be widely available within three years.

Some of those involved have been able to come off the morphine they had been taking for pain relief. Scans showed that tumours considered untreatable had shrunk - including those that had spread to bone and other tissues.

Men with advanced prostate cancer, which kills 12,000 in the UK every year, are not expected to live more than 12 to 18 months after chemotherapy.

"We have patients still in the trial who started in December 2005 and are still doing well two and a half years later. This is very unusual," said De Bono. "Within three months I have had men stop their morphine and say I'm going to see my daughter living in Australia."

No firm conclusions can yet be drawn on whether the drug will significantly increase the lifespan of those with advanced prostate cancer - nobody has yet taken it for long enough.

And although the side-effects so far seem to be mild - the most common being weight gain and fatigue - larger trials are necessary in case a small minority of patients suffer something more severe.

So far 250 men have been treated with the drug worldwide and a global trial of 1,200 is under way which researchers hope will be followed by rapid licensing. They hope to see it the drug available by 2011.

Prostate cancer attracts far less research funding than breast cancer, said De Bono, who played a part in discovering the drug at the Institute of Cancer Research, which is the academic arm of the Royal Marsden.

Abiraterone is now being developed by a US company called Cougar Biotechnology, which is funding the trials.

Independent experts cautioned that the full risks and benefits of the drug will only be known after more years of bigger trials. But John Neate, chief executive of the Prostate Cancer Charity said it was "an exciting development, which has been eagerly anticipated. Early trial results of abiraterone potentially represent the first significant advance in drug treatment of prostate cancer for some time."

Professor Malcolm Mason, Cancer Research UK's prostate cancer expert, said although the early results were extremely exciting "there's a lot more work needed to establish what abiraterone's place will be in treating men with prostate cancer."

The excitement stems from the paucity of drugs to treat men who have the aggressive form of the cancer. Some prostate cancers hardly progress and men are advised to watch and wait rather than undergo surgery and chemotherapy which can leave them impotent and incontinent.

It has long been known that prostate cancer is fuelled by testosterone. The Institute of Cancer Research scientists found that drugs to suppress the hormone have limited efficacy because tumours produce their own. The new drug switches off this production and appears to work in around 80% of patients. De Bono thinks the drug might work in breast cancers too.

He complained at a briefing yesterday that the drug regulatory system is too slow - requiring data on the numbers of deaths prevented by cancer drugs. He is hoping to establish a new measure - of the drop in the number of cancer cells in the blood which could mean faster registration.

· Information on joining trials can be found at:


Sarah Boseley, health editor

The GuardianTramp

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