Searching for the Holy Grail of Prostate Cancer

Earlier this month, a study was released for Abiraterone, a new drug from J&J that it is one of four drugs to ever demonstrate a survival benefit for patients with advanced prostate cancer. The study claimed that in a sample of 1,195 patients given the drug plus a low-dose steroid lived 14.8 months while those given a low-dose steroid plus a placebo survived 10.9 months. When it’s your loved one, every day counts, but will medical economists support the cost-benefit of a drug that extends life 4 months?

Intriguingly, an article in Newsweek pointed out that while the incidence of prostate cancer has risen from 9% to 16% since PSA testing became widely available in the 90’s, the risk of dying of prostate cancer has remained stable at 3% over the past 30 years. This may be because PSA testing has low specificity which leads to a high rate of false positives. Most prostate cancers do not produce symptoms for many years; autopsies have shown that 70% of men who die in their 60s have prostate cancer—and most never knew it.

One in 10 men will develop prostate cancer, and most prostate cancer deaths are due to advanced disease. According to a recent paper published by the Medical College of Georgia on advanced prostate cancer, about 10-20% of the cancers diagnosed are in an advanced stage. Maybe it’s not treatments for advanced cancers that need to be studied, but rather how the disease is diagnosed, so it can be treated earlier, when it’s more manageable.

Another recent study conducted by Cancer Research UK Cambridge Research Institute, found that the new biomarker, MSMB, is found at significantly lower levels in the urine of men diagnosed with prostate cancer than those without the disease. Kate Holmes of the UK’s Prostate Cancer Charity, said in a statement reprinted in a Reuters article, “Given the known limitations of the PSA blood test, finding a technique to accurately diagnose prostate cancer is the Holy Grail of research into the disease.”

J&J’s drug offers immediate hope, but low-cost, specific tests such as MSMB will help detect aggressive prostate cancers earlier and more accurately to narrow the funnel of patients who need treatment. By extension, the test may help doctors match patients to therapy regimes and select those who can benefit from new technology capable of imaging the prostate to monitor treatment efficacy. It would appear that the Grail is a combination of breakthroughs that simultaneously decreases false positives, catches advanced prostate cancer earlier and matches patients with the right therapies that will extend their lives.  With that said, every development and study brings more hope.

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