A drug spearheaded by a Maltese doctor is allowing men with advanced prostate cancer to live longer. The drug, abiraterone acetate, was so successful that a trial of more than 1,000 men was stopped early to allow those taking a placebo to switch to the breakthrough treatment.
“Trials are rarely as strongly positive as this in such sick patients with only months to live from advanced cancer,” Birzebbugia-born Johann de Bono, from the UK’s Institute of Cancer Research, told The Times. The patients taking part in the trial had failed chemotherapy and the disease had progressed despite surgery or drugs to stop the production of testosterone.
Dr de Bono said the benefits are likely to be much bigger in men with less advanced disease. He is also testing abiraterone acetate in patients with breast cancer.
“This data compares very favourably with Herceptin for advanced breast cancer patients,” Dr de Bono said. Herceptin, which started being publicly funded in Malta less than two years ago, has been dubbed the miracle drug for its positive results in patients with a particular type of breast cancer.
Dr de Bono, who has been at the forefront of other cancer breakthroughs, said further data about abiraterone acetate should be available soon but pointed out that the available results were already very impressive.
“Before this, only four drugs had ever shown a survival benefit in this disease,” he said. Dr de Bono had led the trial in one of these other drugs, Cabazitaxel, which was approved by America’s Food and Drug Administration earlier this year but is not yet licensed in Europe.
Prostate cancer is the second leading cancer killer of men, following lung cancer. Figures from the Malta National Cancer Registry show that 397 men succumbed to the disease between 1998 and 2008. In Britain, a man dies from prostate cancer every hour, Dr de Bono said.
In the randomised Phase III clinical trial, 797 men who received abiraterone acetate together with a steroid survived an average of 14.8 months compared to under 11 months for the 398 patients who were treated with the steroid and a placebo. Moreover, patients on abiraterone generally did not experience the side-effects associated with chemotherapy.
Interviewed by the BBC, Richard Pflaum, one of the patients in the trial who was living with pain after being diagnosed with advanced prostate cancer in 2004, said five weeks after starting the drug, the pain was “virtually gone” and he was able to go for long walks and even go back to riding his bicycle. His last scan showed no sign of any active tumours.
Abiraterone acetate works by blocking production of hormones that fuel prostate cancer and is expected to be on the market next year. The preliminary results were presented by Dr de Bono at the European Society for Medical Oncology Congress in Milan last month.
Dr de Bono said the ageing of the population had led to an increase in cancer incidence but mortality was on the decline from common cancers, including breast cancer. Asked whether advances in treatment will render most cancers curable in the next years, he said although much work still needed to be done, researchers believed they could make cancer “increasingly treatable”, with many patients living with it without it causing any problems.
“Nevertheless, we hope to cure more patients in the years ahead,” he said.