An experimental cancer drug combined with targeted hormone treatment could treat an aggressive group of prostate cancers, a European conference has heard.
Delegates at the 2020 European Society for Medical Oncology (ESMO) meeting heard that the precision drug ipatasertib alongside abiraterone enabled some men with prostate cancer to live longer before their cancer worsened than those on abiraterone alone.
Researchers at The Institute of Cancer Research, London, and The Royal Marsden NHS Foundation Trust found that the drug combination stopped the growth a group of cancers that lack a functioning PTEN gene and often rely on AKT, which results in a more aggressive form of the disease.
They say the results from the IPATential150 study could represent a significant advance for men with this form of the disease.
The team assessed the efficacy and safety of ipatasertib with abiraterone in men with advanced prostate cancer who had received no prior treatment.
Out of 1,101 study participants, 521 lacked a fully functioning PTEN gene and each patient was given steroids as well as either abiraterone and ipatasertib or abiraterone and a dummy pill.
The researchers found that ipatasertib plus abiraterone as a first-line treatment enabled men with prostate cancer whose tumours lacked a functioning PTEN gene to live longer before their disease progressed, compared with abiraterone alone.
The risk of tumour progression was reduced by 23% in men treated with ipatasertib plus abiraterone, compared with those on abiraterone alone and the study found that the ipatasertib combination achieved a three-fold increase in complete remissions and about a 20% increase in partial remissions.
The researchers showed that targeting both androgens and AKT signalling together could cut off cancer’s evolutionary escape routes and stop the growth of aggressive cancers.
They describe the initial data as promising, but they point out that overall survival data will require further follow-up.
Study leader Professor Johann de Bono, professor of experimental cancer medicine at The Institute of Cancer Research, London, and consultant medical oncologist at The Royal Marsden NHS Foundation Trust, said: "Targeting hormonal signals with drugs like abiraterone is highly effective in prostate cancer, but we know that tumours can eventually evade the effects of treatment by becoming reliant on other growth signals.
“Our new trial shows that we can treat some men with aggressive cancers even more effectively if we block both growth signals at once by combining abiraterone with a new precision medicine, ipatasertib.
“We found that the new combination treatment could extend the time before the cancer progressed in men whose tumours lacked a functioning PTEN gene. PTEN is one of the most commonly deleted genes in prostate cancer, and as a result men often have a particularly poor prognosis, so it is great news that this study could open up a new precision medicine approach for these patients.”
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