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Prostate cancer patients sought for clinical trials

10/01/2008

UCLA oncologists and urologists have joined together to test promising new therapies for prostate cancer. This collaboration will allow patients to be monitored by experts in the two disciplines while receiving therapies that, in many cases, are not available elsewhere.

Clinical trials currently available at UCLA enroll patients across all stages of prostate cancer. This includes patients who have their cancer confined to the prostate but may be at high risk for recurrence as well as patients with advanced prostate cancer that has metastasized. Many of the trials are designed to build on the efficacy of approved therapies by adding a new drug to an approved treatment regimen. Other studies involve new treatments that target specific molecular abnormalities within the prostate cancer cell.

Depending on the study, patients may be monitored for several months to more than a year, and will have regular appointments at UCLA. Patients are monitored by a UCLA team of research clinicians that includes medical oncologists, urologists, radiologists, pathologists and nurses. This multidisciplinary team works together at the same time in the same clinic, providing a seamless interaction between physicians. Blood draws and additional tests may be required. All research medications will be provided free of charge.

For the purposes of the studies, patients are divided into three categories – early stage, intermediate stage and advanced stage – based on clinical criteria.


Early stage

Patients who qualify for “early-stage” clinical trials include those who have been diagnosed with prostate cancer that is clinically confined to the prostate, and who are about to undergo surgery. Candidates also have clinical and pathological characteristics that may indicate a higher risk for a recurrence of prostate cancer after surgery.

The TARGET study, a collaboration between UCLA and investigators at Memorial Sloan Kettering Cancer Center, is for early-stage patients and will investigate whether patients can go into complete remission when targeted therapy with a short course of hormone therapy is used prior to surgery.

A second clinical study currently underway at UCLA administers an oral agent (Sutent®) for several weeks prior to a radical prostatectomy to see if this may decrease the recurrence of prostate cancer after surgery.

Intermediate stage (PSA recurrence)

Patients classified with “intermediate-stage” prostate cancer include those who have already undergone surgery or radiation treatments, and who have had a recurrence of prostate cancer as manifested by a detectable, rising PSA (prostate-specific antigen) following their initial treatment.

These patients may qualify for a Phase III randomized, control trial investigating the role of pomegranate juice in slowing the rise of PSA. A Phase II trial at UCLA showed a slower rate of PSA increase with pomegranate therapy. Patients in the Phase III trial will either receive pomegranate juice, pomegranate extract or a placebo.

Advanced stage

Patients with “advanced-stage” prostate cancer include those who have developed metastases, which most commonly afflict the bones, although other organs may also be affected. Blocking the effects of the male hormone, testosterone, is the mainstay of therapy for these patients, but hormone therapy eventually stops working in virtually all patients. Clinical trials for advanced-stage prostate cancer patients at UCLA have focused on this hormone-refractory or androgen-independent prostate cancer, for which effective therapies are desperately needed.

The only drug that has been shown to extend survival in hormone-refractory prostate cancer is the chemotherapeutic agent docetaxel (Taxotere®), which, unlike some types of chemotherapy, is fairly well-tolerated by patients. One clinical trial at UCLA will study docetaxel both with and without an anti-angiogenesis drug (a blood-vessel blocker), known as VEGF Trap.

 For patients who have already tried chemotherapy and standard hormone therapy, a second study investigates the oral drug abiraterone, which blocks a key enzyme involved in male hormone production within the prostate cancer cell itself. Male hormones produced within the prostate cancer cell are not blocked by standard hormone therapy, so abiraterone represents a novel approach to the treatment of hormone-refractory prostate cancer.

Contact information

Call (310) 206-2436 or (310) 794-7704 for more information.

Faculty

Matthew Rettig, M.D.
Associate Professor
Division of Hematology/Oncology and
Department of Urology

Arie Belldegrun, M.D.
Professor in Residence
Department of Urology

Jean B. deKernion, M.D.
Professor
Department of Urology

Fairooz F. Kabbinavar, M.D.
Adjunct Associate Professor
Division of Hematology/Oncology

Allan Pantuck, M.D.
Associate Clinical Professor
Department of Urology

Robert E. Reiter, M.D.
Professor
Department of Urology





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