A clinical trial led by a team of BC-based researchers partly funded by the TFRI has revealed a more efficient way to treat metastatic castration-resistant prostate cancer (mCRPC), an aggressive form of disease with low survival rates.
The trial, which enrolled over 200 patients from six different cancer centres across British Columbia, tested the efficacy of two drugs already used to treat mCRPC: enzalutamide and abiraterone.
“These two hormone therapies are commonly used to treat mCRPC but we hadn’t yet learned the optimal sequence in which these drugs should be administered,” said Dr. Kim Chi, head of BC Cancer and one of the team’s lead investigators. “Through the trial we discovered that administering abiraterone acetate first, with enzalutamide afterwards, was better than the opposite sequence, delaying cancer progression by an average of four months.”
Enzalutamide and abiraterone target androgen receptors. While they function in different ways, their main goal is similar: to block testosterone from reaching cancer cells, cutting off the supply of fuel they need to grow.
The results of the trial, which were published in Lancet Oncology (November 2019), will provide doctors with better ways to use these drugs, allowing patients to quickly benefit from this research.
“We’re very pleased that this study will be able to change practice right away, while also providing clues on the mechanisms of sensitivity and resistance to androgen-targeted therapies in prostate cancer, which could inform future work,” said Dr. Chi.
The team will now proceed with its mission of finding newer and more efficient ways to treat this deadly disease.
“This also provides clues on the mechanisms of sensitivity and resistance to androgen receptors-targeted therapies in prostate cancer,” said Dr. Chi. “Our future work will be evaluating if there are predictive biomarkers of response or resistance that could help us to select the most appropriate therapy for each of our patients.”
Optimal sequencing of enzalutamide and abiraterone acetate plus prednisone in metastatic castration-resistant prostate cancer: a multicentre, randomized, open-label, phase 2, crossover trial
Daniel J Khalaf, Matti Annala, Sinja Taavitsainen, Daygen L Finch, Conrad Oja, Joanna Vergidis, Muhammad Zulfiqar, Katherine Sunderland, Arun A Azad, Christian K Kollmannsberger, Bernhard J Eigl, Krista Noonan, Deepa Wadhwa, Andrew Attwell, Bruce Keith, Susan L Ellard, Lyly Le, Martin E Gleave, Alexander W Wyatt, Kim N Chi
This study was partially funded by a Terry Fox New Frontiers Program Project Grant to Targeting the adaptive molecular landscape in castrate-resistant prostate cancer