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institute of cancer research

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An immunotherapy drug can be effective in some men with advanced prostate cancer, a major trial has shown.

The phase II clinical trial, led by the Institute of Cancer Research and the Royal Marsden, involved 258 men with advanced prostate cancer who had run out of all other options on treatment.

The men had stopped responding to the main treatment options.

According to researchers, a small proportion of men, described as “super responders”, remained well even after the trial ended, despite a very poor prognosis before treatment.

Last week it was reported the same drug had proved effective in treating advanced head and neck cancers.

Immunotherapy uses our own immune systems to recognize and attack cancer cells.

The therapy is already being used as a standard treatment for some cancers such as melanomas – and being tested on many others too.

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The study found that one in 20 men with advanced prostate cancer responded to the drug pembrolizumab – and saw their tumors actually shrink or disappear altogether.

The study, published in the Journal of Clinical Oncology found that although a relatively small number, some of the men gained years of extra life.

A further 19% saw some evidence of improvement.

Most patients in the study lived for an average of eight months on the drug.

The most dramatic responses were seen in patients whose tumors had mutations in genes involved in repairing DNA.

Researchers are now investigating whether this group might benefit the most from immunotherapy in a larger trial.

But first, a test to pick out who will respond best is needed, so that doctors know which patients to give it to.

The number of people diagnosed with prostate cancer has been rising over the last 10 years.

This is probably because the population is getting older and more people are having PSA tests.

Around 30% of men with advanced or stage four prostate cancer survive their cancer for five years or more after diagnosis.

Last week, a separate trial found the same drug kept some people’s advanced head and neck cancers at bay for an average of two years – five times longer than under chemotherapy.

Both studies are part of a growing body of research suggesting immunotherapy could offer hope to an increasing number of cancer patients.

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Researchers have found that a blood test may be able to save lives by finding cancers that have started to grow again after treatment.

Scientists at the Institute of Cancer Research (ICR) in London found traces of breast cancer eight months before doctors would normally have noticed.

In the trial, the test found 12 cancers out of the 15 women who relapsed.

Experts said there was still some way to go before there was a test that could be used in hospitals.

Surgery to remove a tumor is one of the core treatments for cancer.Blood test could predict breast cancer relapse

However, a tumor starts from a single cancerous cell. If parts of the tumor have already spread to another part of the body or the surgeon did not remove it all then the cancer can return.

Fifty-five patients who were at high risk of relapse because of the size of the tumor were followed in the study published in Science Translational Medicine.

The scientists analyzed the mutated DNA of the tumor and then continued to search the blood for those mutations.

Fifteen patients relapsed and the blood test gave advanced warning of 12 of them.

The other three patients all had cancers that had spread to the brain where the protective blood-brain barrier could have stopped the fragments of the cancer entering the bloodstream.

The test detected cancerous DNA in one patient who has not relapsed.

None of the women in the study were told that cancerous material had been detected as it would have been unethical to base decisions on such an unproven prototype.

However, the hope is that detecting cancer earlier means treatments including chemotherapy can start sooner and improve the odds of survival.

The analysis of the blood is relatively cheap. However, investigating the DNA of the tumor for mutations in the first place is still expensive.

The price is coming down as the field of cancer medicine moves from treating tumors in whichever part of the body they are discovered, towards drugs that target specific mutations in tumors.

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