Game theory-wise treatment plans to advance the standard of care include men with advanced prostate cancer
August 9. 2018. Game theory can be used to identify potential flaws in current cancer treatment approaches and to select new strategies to improve outcomes in patients with metastatic cancer, according to a review study published online today, August 9, in JAMA Oncology.
Authored by a mathematician, an evolutionary biologist, and clinical physicians from the Moffitt Cancer Center and Maastricht University in the Netherlands, the study challenges decades-old methods. The usual method of treating metastatic cancer involves repeatedly administering the same drug(s) until disease progression. The drugs are given according to Maximum Tolerated Dose (MTD), i.e. the highest dose of a drug or treatment that does not cause intolerable side effects. The maximum tolerated dose is decided via clinical trials by testing increasing doses on different groups of people until the highest dose with acceptable side effects is found.
August 9, 2018. Certain molecular drivers of cancer growth are “undruggable” – it’s been nearly impossible to develop chemicals that would block their action and prevent cancer growth. Many of these molecules function by passing cancer-promoting information through a gate in the nucleus, where the instructions are carried out.
Now researchers at the Sidney Kimmel Cancer Center – Jefferson Health have found a way to block the nuclear gates used by these molecules, and have shown that this inhibition can halt aggressive prostate cancer in mice implanted with human tumors.
“We found that a particular gatekeeper, the nuclear pore protein called POM121, traffics molecules that boost tumor aggressiveness,” Dr. Rodriguez-Bravo said. “Blocking this gatekeeper prevents several molecules from reaching their targets in the nucleus, thus decreasing tumor growth.” The researchers also showed that blocking POM121 transport helps restore chemotherapy efficacy in pre-clinical models of the disease.
An international collaborative study is one of the first to demonstrate that a blood test can predict how patients with advanced prostate cancer will respond to specific treatments, leading to improved survival.
The study used a liquid biopsy test developed by molecular diagnostics company Epic Sciences that examines circulating tumor cells (CTCs) in blood samples from patients with advanced prostate cancer who are deciding whether to switch from hormone-targeting therapy to chemotherapy. CTCs are cancer cells that leave a tumor, enter the blood stream and invade other parts of the body, causing the spread of cancer.
The test identifies whether or not a patient’s CTCs contain a protein called AR-V7 in the cell’s nucleus. The researchers set out to determine whether the presence of this protein predicted which treatment would best prolong a patient’s life.
They found that patients who tested positive for AR-V7 responded best to taxane-based chemotherapy while those who tested negative for the protein responded best to hormone-targeting therapy with drugs called androgen-receptor signaling (ARS) inhibitors. These are the two most widely used drug classes to treat advanced prostate cancer.
Judd Moul reviews the history of the U.S. Preventative Services Task Force screening guidelines and highlights the US trends and patterns of disparities in cancer mortality among U.S. counties from 1980 to 2014. Full Video online at UroToday July 12 2018. Our transcript, August 7 2018, is from the section Moul calls “the bottom line.”
“There have been no randomized trials of prostate cancer screening for black men. The only 2 randomized screening trials (one in Europe, one in the USA) included very few African American men. And one of the things that really bothers me … Why hasn’t there been … a true randomized trial focusing on African American men, to answer the question … “Is it beneficial to screen for prostate cancer in this high risk group? What is the proper age to initiate screening for African American men? Is it 40, 45, 50, or is it 55? We don’t know that, it’s only speculation. Continue reading “Screening for Prostate Cancer in African American Men – Judd Moul”
Discovery could lead to treatments for this condition, cachexia
PSA Rising August 5, 2018 (NEW YORK, NY, June 6, 2018)—About one-third of all cancer deaths are caused not by the cancer itself but by cachexia—a debilitating muscle-wasting syndrome that affects an estimated 80 percent of advanced cancer patients. Cachexia is linked to reduced tolerance for cancer therapy, poor quality of life, and accelerated death, but there are no effective treatments and its cause is still largely unknown.
A new multicenter, internal study led by researchers at Columbia University Irving Medical Center suggests that an overload of zinc in patients’ muscles may be the culprit. The findings, published online June 6 in Nature Medicine, could pave the way for the development of drugs to treat or prevent muscle wasting in advanced cancer patients. Continue reading “Excess Zinc in Muscles Contributes to Wasting Syndrome in Cancer”