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"Again, a clinical trial modifying the treatment of prostate cancer has been published, and it will lead to a new global approval of drugs," said Viennese oncologist Michael Krainer (MedUni Vienna / AKH ) to the APA. He and Linz Urologist Wolfgang Loidl (KH Merciful Sisters) are mentioned in the Appendix of the Investigation as "Investigators"
Castration Against Carcinoma
The Background: Even Prostate cancer becomes incurable when metastases appear. Therefore, the drug tries to prevent the progression of the disease and the formation of secondary tumors. Patients with prostate cancer often respond very well to a suppression of androgen production (especially testosterone), which is equivalent to castration. But the effect usually only lasts for a while. The reappearance or progression of the disease is mainly due to a rapid increase in levels of PSA (specific prostate antigen) in the blood.
New drugs such as apalutamide or enzalutamide further inhibit the androgen signaling pathway by binding to the androgen receptor on tumor cells and blocking the cascade of androgen signals to the core. Following the use of such agents in already metastatic prostate cancer, it is currently used to prevent the development of secondary tumors in prostate cancer patients and rapidly increase PSA levels in the blood ( doubling every ten months or more). Krainer said, "We call this the stage of non-metastatic and castration-resistant prostate cancer."
Earlier this year, the SPARTAN study with approximately 1,200 patients with the drug Apalutamide was published in the New England Journal of Medicine. contributed to urologists Krainer and Graz. "In this study, apalutamide and androgen suppressive therapy reduced the risk of metastasis or death by 24 months compared with placebo by 72%," writes Matthew Smith of Mbadachusetts General Hospital ( Boston, United States). ), in a comment. He was the lead author of the SPARTAN study
Studies on New Methods of Treatment
The current commentary for the New England Journal of Medicine (June 28) was almost identical to Smith's comments on the subject. SPARTAN study Written study PROSPER. Maha Hussein (Chicago) and his co-authors also treated prostate cancer patients with a castration-resistant disease with the androgen signal inhibitor, enzalutamide.
In total, about 1,400 patients were involved. During a 22-month follow-up period, the metastasis rate was 71% lower than that of the placebo group
Median (half of the patients was above this value, the other half lower ) with enzalutamide (160 milligrams once a day) in the form of tablets) treated 36.6 months before metastasis, 14.7 months in the control group (placebo). Instead of relying on chemotherapy after only 17.7 months, this was the case only after 39.6 months for those treated with the new drug. At the end of the observation period, 49% of patients had died in the placebo group and 23% in the verum group (true drug)
Towards more effective treatment
The study could In many cases, be part of the SPARTAN study Patients with prostate cancer without metastasis detected, but with clear evidence of disease progression, pave the way for more effective pharmacotherapy . According to US statistics, this affects 50,000 to 60,000 men a year in the United States alone. International work is underway on the development of more refined methods to detect even earlier possible metastases in prostate cancer.
Prostate cancer is the most common cancer in men in Austria. Each year, about 1,150 people die. Every year, 5,000 Austrians are diagnosed with prostate cancer. This corresponds to about a quarter of all neoplastic diseases in men. In the EU, prostate cancer was diagnosed in 2015 among 365,000 men – the second most common cancer among men in the world. Patients with hormone-resistant prostate cancer need additional treatment options. According to American estimates, 10 to 20% of all prostate cancers are resistant to castration within five years. Apalutamide is already approved for these patients in the United States
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