Clinical Trials for Prostate Cancer
The prostate cancer program at Tulane offers our patients access to a variety of clinical research trials for the treatment or prevention of prostate cancer. Clinical trials provide patients cutting-edge investigational treatment / prevention options that are not yet widely available but are often the precursors to tomorrow’s standards of clinical cancer care. Clinical research is how we learn to better treat and prevent cancer. It helps us to build a body of knowledge that is science-based as we work toward our ultimate goal of finding a cure. To review the prostate cancer trials currently offered at Tulane Cancer Center, please click here.
Two international trials in which Dr. Sartor played key roles revealed significant results in 2018.
The first showed that African-American men treated with the immunotherapy drug sipuleucel-T had a median nine-month overall survival advantage compared to Caucasian men with the disease, according to an analysis of 1,900 patients who received the treatment between 2011 and 2013. Dr. Sartor, lead author of the study, presented these data at the 112th American Urological Association annual meeting in Boston last year. “This is the first time that I have ever seen a prostate cancer treatment seemingly work better in African Americans,” said Sartor. “These new findings are very encouraging given that African-American men with prostate cancer have a mortality rate more than twice as high as Caucasian men and historically have presented with aggressive disease and have had worse outcomes in both real-world settings and controlled clinical trials.”
The second study, which was the lead article in the Feb. 2, 2018, issue of The New England Journal of Medicine, showed that adding two years of hormonal therapy to radiation treatment significantly improves survival rates for patients whose cancer returned years after surgery to remove the organ. “It more than cut the risk of prostate cancer death in half, which is quite substantial,” said Dr. Sartor. “For the first time, we now have a demonstration that hormonal therapy added to radiation can help save lives for men who have recurrent prostate cancer after surgery. That’s a very big statement.” Dr. Oliver Sartor was co-author of the study and medical oncology chair of the national committee that ran the nearly two decades-long trial. He said the study will likely help shift the standard of care for the approximately 30 percent of prostate cancer patients whose cancer returns.
Additionally, a study published in the February 7, 2019, issue of JAMA Oncology revealed that more than 17 percent of prostate cancer patients are born with genetic variants that can be associated with a higher risk for various cancers. Dr. Sartor was lead author on this study, conducted in conjunction with researchers from the genetics firm Invitae. The research, which is the largest study to date on the genetics of prostate cancer, also found that guidelines for genetic testing at the time of the study missed a substantial number of patients, suggesting broader testing is warranted. “This research shows the genetic risks associated with prostate cancer have been underestimated and provides support for expanding testing to include an increased number of prostate cancer patients,” said Sartor. “Expanding the use of genetic testing in prostate cancer patients can inform treatment strategies and potentially suggest treatment with targeted therapies or clinical trials. In addition, testing can provide valuable information for a patient’s family, allowing for increased screening among those at risk that can potentially help prevent additional cancer deaths.
The early results of a clinical trial published in the May 28, 2020, edition of the New England Journal of Medicine reveals for the first time that therapies based on tumor genetics – specifically DNA repair defects – may also show promise in treating some men with metastatic castration-resistant prostate cancer (mCRPC). “This is important not only because of the potential benefit that patients can receive, but it also represents a conceptual advance based on tumor genetics in terms of selecting therapies that can offer hope for mCRPC patients,” said Dr. Sartor. “With this advance, there will be increasing focus on underlying genetic alterations in tumors and the application of specific therapies based on those alterations – something we call precision oncology. Precision oncology has advanced in other tumors, notably lung and melanoma. This represents the first such advance in prostate cancer, which is practice changing.” Tulane News: Study targeting tumor genetic mutations yields ‘practice changing’ results for prostate cancer treatment