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Cancer is among the scariest diagnosis a person can receive. According to the American Cancer Society's "Cancer Facts & Figures 2016" report, there were an estimated 1.69 million new cases of cancer diagnosed in 2016, along with a projected 595,690 cancer deaths. With the exception of heart disease, cancer is the leading cause of death in the United States -- and it's soon likely to become the leading killer.
For men, the most commonly diagnosed cancer is prostate cancer, with an estimated 180,890 diagnoses in 2016. Prostate cancer is also the second deadliest cancer type for men, responsible for a little over 26,100 deaths last year, just slightly ahead of colon cancer, and trailing only lung cancer.
If there is some semblance of good news, it's that prostate cancer detection methods and treatments have improved greatly over the past four decades. Between 1975 and 1977, only 68% of men survived five years post diagnoses. Between 2005 and 2011, this figure had risen to an eye-popping 99%. Yet, despite this clear improvement in survival, more than 26,100 men are still dying annually from the disease.
This experimental focal therapy could be a game-changer
However, a brand-new minimally invasive therapy developed by private-held biotech company STEBA Biotech and scientists at the Weizmann Institute of Science in Israel could completely change the game for low-risk prostate cancer patients in the years that lie ahead.
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The drug developed by researchers at the Weizmann Institute and STEBA Biotech is unique because it's the first therapy to offer a focal cure in prostate cancer. In other words, it aims to target just the tumor and surrounding tissues while leaving healthy tissues and the surrounding organs almost entirely untouched. It would also represent a sort of meld of the active surveillance approach and aggressive forms of treatment.
The drug in question is known as Tookad, and it's currently under review by the European Medicines Agency following the completion of European phase 3 study. What makes Tookad so unique is that it's a vascular-targeted photodynamic therapy. In plainer English, this means Tookad is injected into the lobe of the prostate where tumors are present, and the drug is activated by a certain wavelength of light, which then cuts off blood supply to the surrounding tissues and, in effect, chokes the tumor of oxygen until it dies. This light comes from optical fibers that are fed into the same lobe of the prostate as the tumor.
What the researchers have found is that the treatment procedure is quite easy to perform, and that it often lasts less than 90 minutes. What's more, it's easily repeatable and doesn't require a heavy amount of investment, meaning any surgical center would, in theory, be able to house the equipment needed to treat low-risk prostate cancer patients.
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By now you're probably wondering how well it worked in clinical trials. The 413-patient trial that was set across 10 European countries allowed nearly half of all patients on Tookad to remain in complete remission after two years compared to just 13% in the control group. Additionally, the chance of progression to a more serious stage of disease was three times lower in the Tookad arm than the control group. Whereas 6% of Tookad arm patients needed radical therapy, such as a prostate removal or complete irradiation of the prostate, 30% of control group patients needed radical therapy. Lastly, Tookad doubled the time of disease progression to 28 months compared to the control group. On all accounts it was a resounding success.
Understandably, it could take time for this next-generation therapy to hit pharmacy shelves in Europe. Unlike the U.S., where drugs that are approved by the Food and Drug Administration instantly become available, European countries approve reimbursements one-by-one, which slows the roll out process. Nonetheless, the data appears to suggest that an approval may be likely.
Tookad could join another game-changing prostate cancer therapy
If approved by the EMA, Tookad would represent the dawn of a new age for prostate cancer therapy. However, it doesn't mean that some of today's key therapies would be tossed to the wayside. There would, in fact, just be a broader array of treatment options to fight the disease.
Image source: Astellas Pharma.
Arguably the biggest advancement in years was the emergence of Xtandi, an advanced prostate cancer drug for men whose prostates cannot be surgically removed. The drug, which was developed by Medivation (which is now owned by Pfizer (PFE 0.11%)) and Astellas Pharma (ALPMY 0.36%), is approved as a treatment for both first- and second-line advanced prostate cancer drug. Though Xtandi was already impressive as a second-line treatment – it wound up making a cancer immunotherapy treatment known as Provenge essentially obsolete – it's Xtandi's first-line results that wowed the scientific community.
In the phase 3 PREVAIL study that led to its first-line label expansion, Xtandi reduced the risk of death by 29% compared to the placebo, and lowered the risk of radiographic progression or death by 83%. The really telltale result was that it delayed the time by which prostate cancer patients had to initiate chemotherapy by a median of 17 months longer than the placebo. Based on these results, it's probably no shock that Xtandi may push to nearly $5 billion in annual sales by 2020, per analyst estimates.
That marks two therapies (Xtandi and Tookad, assuming approval in the EU) that have demonstrated a durable effect on the most common cancer type for men.
Cancer is a scary diagnosis, but for men a prostate cancer diagnosis is no longer a death sentence – and that's a good thing.
