Analysis of metastatic prostate cancers suggests treatment options

[Paul Edwards]

Researchers at the University of Santa Cruz and UCLA have developed a new analysis of the genetics and the protein expression of cells involved in metastatic prostate cancer.   The goal will be to turn a research tool like this into something that is readily accessible for oncologists and their patients.

 

Click here to read more about this study. [Warning; this article is fairly technical.]

[Paul Edwards]

Dr Stephen Strum is an eminent American oncologist who specialises in prostate cancer.  He is now semi-retired, providing personalised online advice to a small number of patients from his home in Oregon.  I would highly recommend his 2013 ebook “Prostate Cancer. Essential Concepts for Survival”.

 

 

Dr Strum has sent the following note to his patients about this study by the researchers at the University of Santa Cruz and UCLA:

“My take on this article is that it:

 

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        is based on autopsy samples of obviously far-advanced PC patients, who have had many treatments over many years.  Their disease is heavily mutated as a consequence of time, treatments and other factors (possibly diet, lifestyle) that we are not aware of.

   

•        focuses on genomic, phosphoproteomic, and transcriptional (GPT) findings in the autopsy tissue to discern possible targets that are in turn focused on kinase inhibitors that have been studied in non-human models, or are in clinical trials, or are in use in   various tumors other than PC or are just now being studied in PC e.g. erlotinib.  These kinase inhibitors are super-expensive and are not without some serious toxicities.  Some of us are exploring available kinase inhibitors based on currently available technology, such as Guardant360 gene alteration analysis provided by Guardant Health i.e.  so-called “liquid biopsy” done on peripheral blood and commercially available and paid for by most insurance companies.  The latter is “available” new technology in contrast to that which will likely not be available for many years.

   

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  ·  did not apply the conclusions to living patients, who are not so far advanced, to see if there is a high level of translation. By translation I mean moving from the bench (research) to the trench (reality).

   

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  ·        The paper is highly esoteric with many technical nuances. This may be an approach that comes to pass but the proverb “the proof of the pudding is in the eating” is paramount in how this publication affects the common man with PC who is not curable with local ablative therapies.

   

 

 

That is my take on this paper with about a half dozen pages yet to be read.  Again, I emphasize, this paper is speculative on what might be available for men with so-called CRPC (castration resistant PC).  But what about what can be done right now?

 

 

 

What I personally find in my consultations with men with PC is that:

 

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  ·      basic issues that have been around for 30 years are not even discussed and dealt with,

   

• ·      most men are under-staged re extent of disease and thus inappropriately treated,

   

• ·      available technology re labs & imaging are not used, even in academic centers,

   

• ·      assessment of genetic alterations by liquid biopsy and by tissue is rarely done,

   

• ·      attention to integrative care focusing on cancer fuels as recognized “hallmarks of cancer” are ignored.

   

 

All of these issues can be addressed and do not require use of tyrosine kinase inhibitors that cost many thousands of dollars per month.

 

The “here and now” is for me far more important than what might be in 10 or more years, or might not be affordable by 80% of the population.”