When prostate cancer is caught early, there are effective treatments that can provide a cure. If the cancer has spread, treatment becomes much tougher. Now a new trial is evaluating immunotherapy in patients with advanced cases of the disease. 
Eighty-five-year old Ralph Stuart has been battling prostate cancer for the past nine years. At first, the cancer was slow-growing, but by 2011, his disease took a turn.
“At that time, it started to spread, spread to the bones,” said Austine Stuart, Ralph’s wife.
Ralph’s doctors tried hormone treatment but his cancer kept spreading. That’s when the Stuarts found Dr. Akash Patnaik. Dr. Patnaik was enrolling patients in a cutting-edge clinical trial known as Checkmate 650.
“With the PSA elevating so much and nothing else seemed to work we said this won’t hurt,” said Austine.
Patients in the trial receive an IV infusion of two drugs that boost the immune system: ipilimumab and nivolumab.
Akash Patnaik, MD, PhD, an Oncologist from the University of Chicago said, “We are trying to enhance the ability of the good immune cells, the T-cells are able to enter the tumor and overcome this fortress of immunosuppression.” 
Dr. Patnaik says when given separately, the drugs have little effect on patients with advanced prostate cancer, but together, certain patients, like Ralph Stuart do very well.
“He had a very dramatic response even after receiving the first cycle of treatment”, said Dr. Patnaik.
At its highest, Ralph’s PSA level, a measure of prostate cancer, was over 500. Right now, it’s not detectable, the sign of a possible cure.
“There is a solution for a lot of people,” Austine told Ivanhoe.
The two drugs have already gained FDA approval for advanced kidney cancer and metastatic lung cancer.  The Checkmate 650 trial is ongoing at five centers across the U.S. including the University of Chicago.

Contributors to this news report include: Cyndy McGrath, Field and Supervising Producer; Hayley Hudson, Assistant Producer; Roque Correa, Videographer and Editor.

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REPORT:    MB #4479

BACKGROUND: Prostate cancer is cancer that occurs in the prostate, a small walnut-shaped gland in men that produces the seminal fluid that nourishes and transports sperm. Prostate cancer is one of the most common types of cancer in men. Usually prostate cancer grows slowly and is initially confined to the prostate gland, where it may not cause serious harm. However, while some types of prostate cancer grow slowly and may need minimal or even no treatment, other types are aggressive and can spread quickly. Prostate cancer that’s detected early, when it’s still confined to the prostate gland, has a better chance of successful treatment.

TREATMENT: If you have an advanced stage of prostate cancer (stage III and IV), it means the disease has spread outside the prostate gland. Doctors can treat this type of cancer, but they can’t cure it. Still, there are good options that can ease symptoms and help patients live a long, active life. The main options for treating advanced prostate cancer include radiation, hormone therapy, surgery, or active surveillance.
NEW RESEARCH: Akash Patnaik, MD, PhD, an Oncologist at the University of Chicago recently launched a phase 2 clinical trial, known as CheckMate 650, for men with metastatic prostate cancer that is resistant to hormonal therapy. The study combined two immune system-boosting drugs: ipilimumab and nivolumab. The trial is currently open at five institutions in the United States and four in France. These drugs, both monoclonal antibodies, work in slightly different ways. Ipilimumab blocks a protein called cytotoxic T-lymphocyte antigen 4 (CTLA-4) that sits on the surface of T cells and prevents them from doing their job, attacking cancerous cells. When ipilimumab, the first known immune checkpoint inhibitor, attaches itself to CTLA-4 on T cells, it can help those cells get back in action, destroying cancer cells. It also inhibits activity of other cells, such as regulatory T cells, that further hinder an immune response. Nivolumab blocks a different pathway, known as PD-1. Tumors exploit the pathway to protect themselves from T cells. PD-1 is an immune checkpoint that shuts down T cell-mediated attack on tumors. PD-1 inhibitors, such as nivolumab, can restore the ability of T cells to penetrate and attack tumors.


John Easton, PR

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