A world-first Australian clinical trial has found that a new combination of therapies could slow the spread of advanced prostate cancers.
The EVOLUTION Phase II Clinical Trial has found combining the radiopharmaceutical Lutetium-177-PSMA (LuPSMA) with immunotherapy agents nivolumab and ipilimumab can slow the spread of prostate cancer more effectively than LuPSMA alone.
The trial was led by the Australian and New Zealand Urogenital and Prostate Cancer Trials Group (ANZUP) in collaboration with the NHMRC Clinical Trials Centre at the University of Sydney and co-funded by Prostate Cancer Foundation of Australia.
After one year, 33 per cent of people receiving the combination treatment remained progression-free based on their levels of Prostate Specific Antigen, compared to just 17 per cent of those treated with LuPSMA alone.
Lead investigator and Medical Oncologist, Professor Shahneen Sandhu, said the results were encouraging and may represent a step forward in the treatment of advanced prostate cancer.
"We are pushing the needle in terms of developing new treatment options for the deadliest forms of prostate cancer," Prof Shahneen said.
"Importantly, the translational research that follows will help us identify which patients are most likely to benefit from this combination therapy.
"Nearly 10 years ago we discovered that targeted radiation therapy LuPSMA is an effective treatment for advanced prostate cancer, slowing the spread of disease and improving the quality of life for those affected.
"However, high numbers of people still have their disease progress while on LuPSMA, which means we need to keep building on existing research to find new ways of combatting treatment resistance.
"The EVOLUTION Phase II Clinical Trial allowed us to do just that, by harnessing two immunotherapy drugs in combination with LuPSMA.
"Until now, there hadn't been a way to make immunotherapy work well for prostate cancer. The EVOLUTION clinical trial has shown that adding nuclear medicine treatment can help immunotherapy work better, offering new hope for people with advanced prostate cancer.
"This is an exciting new discovery."
PCFA CEO, Anne Savage, welcomed the findings.
"Prostate cancer is the most commonly diagnosed cancer in Australia, with more than 26,000 men diagnosed each year," Ms Savage said.
"It's estimated that around 10-20 per cent of men diagnosed with prostate cancer will end up with metastatic castration-resistant prostate cancer - one of the most challenging forms of prostate cancer to treat.
"Findings from the EVOLUTION Trial provide new hope for improved outcomes and has the potential to help save the lives of nearly 4,000 Australian men who die from the disease each year."
ANZUP CEO, Adjunct Professor Samantha Oakes, said the trial was the first in the world to test this combination of treatments.
"Without a doubt, these findings have the potential to transform how we treat a subset of people with advanced prostate cancer," she said.
"We have seen an enormous improvement in survival rates for those diagnosed with prostate cancer over the years, thanks to ongoing donations towards medical research, but we still have a way to go yet.
"Clinical trials and new treatments like this will continue to change the future and save many more lives."
Adj. Prof Oakes said researchers are now working to better understand why some people respond to the treatment while others don't, with the goal of refining and personalising future therapies.
