Home » “Prostate cancer, here’s the therapy” – breaking latest news

“Prostate cancer, here’s the therapy” – breaking latest news

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SALERNO. Dr. Matteo Ferro, urologist at the European Institute of Oncology, in a recent meta-analysis published in Critical Reviews Oncology / Hematology highlights how the new hormonal oral drugs are more effective than chemotherapy to combat castration-sensitive disease. We are talking in particular of prostate cancer, a killer that kills, according to the Airtum, more than 7 thousand men a year in Italy, and that does not stop in front of the early diagnosis campaigns, made possible by the Psa dosage a specialist urological and oncological evaluation. And it is precisely from the synergy of the urologist of Salerno origin with a team of other young researchers, that the discovery comes, which could offer more hope to men with metastatic prostate cancer.
Dr. Ferro, What are the concrete possibilities that current medical science offers to our fellow citizens suffering from this serious disease?
As we know, when prostate cancer is not resolved with radical prostatectomy surgery or with radiotherapy and it recurs, or when it is diagnosed when unfortunately it is already in an advanced stage, the disease can be stopped with therapy. of androgen deprivation, basically a chemical castration. Way back in April 1941, Charles Huggins and Clarence Hodges published their astonishing results showing how men with prostate cancer who were surgically castrated went into disease remission. Eighty years later, we still speak of hormone therapy as the most effective weapon for this lethal condition.
So is hormone therapy the foundation of advanced prostate cancer treatment?
That’s right. In addition to drugs that allow chemical castration to be achieved, new agents such as abiraterone, apalutamide and enzalutamide have been discovered, capable of making chemical castration even more effective.
Why is castration not enough to contain the tumor and new hormonal drugs are even needed?
Because chemical castration clears the testosterone produced by the gonads, but not that produced by the tumor itself, or at the level of the adrenal glands. After a phase of “quiet”, which can last for years, during which the disease, even if metastatic, is contained with castration (“sensitive castration disease”), the disease “wakes up” and manages to exploit even those minimal quantities of extragonadal testosterone to proliferate. And it is in the “resistant castration” setting that the new oral hormonal agents mentioned were introduced.
Let’s talk about his discovery. The official journal of the European School of Oncology has recently been published in the prestigious Critical Reviews Oncology / Hematology journal. What are the foundations on which you have worked?
In oncology, advances are proceeding through randomized clinical trials. Current randomized studies suggested that even during the castration sensitivity phase it is of great benefit to introduce a course of systemic therapy, be it hormonal or chemotherapy. This was a big step forward and represented the area of ​​research we dedicated ourselves to, as well as the premise for our discovery.
What was the goal you set yourself with this work?
When oncologists treat a patient with advanced prostate cancer as part of a multidisciplinary team, we know that we have two therapeutic options that can prolong life expectancy: Taxane-based chemotherapy (docetaxel) and the new hormonal agents enzalutamide, apalutamide, abiraterone. In reality there are no direct comparison studies, but authoritative meta-analyzes concluded that the efficacy of chemotherapy and hormone therapy in this setting was comparable. An unexpected and, in some respects surprising, result, because while chemotherapy is administered for only four months, hormone therapy is administered continuously for months, if not years. With this work, we have gathered rigorous evidence on a meta-analytic basis that hormone therapy is more effective than chemotherapy in prolonging survival.
A sensational discovery. How did you get there and not others?
Because we used a different approach, based on our previous research. In practice, while other authors had compared each single hormonal agent with chemotherapy, obtaining inconclusive results, we compared the three hormonal agents treating them together as a “class”, the class of Arat (agents directed against the androgen receptor). In this way we have achieved the statistical power that has allowed us to gather evidence that therapy with an Arat confers a survival advantage over that based on docetaxel. Of course, randomized studies are needed, but in the meantime this type of research has very important implications, especially in our country.
Why?
At the moment, no Arat is unfortunately reimbursed in the sensitive castration setting by the Italian national health system. Obviously, I will not enter into the merits of this decision, but as a doctor and citizen I hope that the competent institutions can re-evaluate it.
Doctor Ferro, A punchline?
Allow me to take the opportunity to thank my Director, Professor de Cobelli, full professor of Urology at the Università degli Studi di Milano Statale and all members of the Team, who have made a decisive contribution to this work. For all my fellow citizens who read me I would like to share the perspective of those who fight against a disease that is still incurable when it is discovered too late.
Prevention is always the key word, it means to us.
Exact.(re.sa.)
© breaking latest news.

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