A Prostate Centre patient has become the first British patient to receive Provenge, a new drug designed to prolong life in advanced prostate cancer. He had to travel to New York for the treatment as it is not available yet in the UK.
Once prostate cancer has spread beyond the gland itself to the lymph nodes or skeleton, it is usually treated with hormone deprivation. Medications such as Casodex or Zoladex deprive prostate cancer cells of the male hormone testosterone they require to grow and divide (in effect, chemical castration), and result in remission.
Unfortunately, after a time, some cancer cells become castration-resistant, and the PSA begins to rise. There are other treatments possible at this time which can be used sequentially to keep the cancer in remission, including alternative hormone therapy, or taxotere (docetaxel), a chemotherapy treatment which is given intravenously in cycles every three weeks and is now widely available in the UK.
However, the New England Journal of Medicine recently reported the use of Provenge (sipuleucel-T), a new type of immunotherapy that stimulates a response against prostate cancer based on tumour recognition (NEJMed 2010,363:411-22). An improvement in survival of 4.1 months is reported, with only minor side-effects occuring within a day after infusion and subsiding within the next few days.
It is available only in the US at present, where the cost of treatment is around £60,000. But there’s a chance it may become available soon in the UK, at least for private patients, according to discussions we have had with the manufacturer.
Oncologist Dr Heather Payne says: “It’s a very exciting time for prostate cancer, with new drugs coming on to the scene for this group of patients. Provenge is one of several drugs that are showing great promise in clinical trials for castration-resistant prostate cancer. Other compounds being tested include abiraterone, zibotentan, MDV3100 and carbazitaxel”.
The results of some of these studies will be known in the coming months. Our specialists will be watching them closely, and we’ll keep you informed of developments.