Caring Currents

A New "Miracle" Drug Regimen Saves Men With Inoperable Prostate Cancer

Last updated: Jun 23, 2009

Image by Niffty.. used under the creative commons attribution license.

Thanks to an experimental new drug regimen, two men with inoperable prostate tumors who would have been "getting their affairs in order," are now cancer free, the Mayo Clinic announced this week. The results for the two men were so astonishing the clinic publicized them, even though it's unusual to announce a breakthrough based on only two cases.

The miracle treatment used an experimental drug called MDX-010, also called ipilimumab, an immune system antibody. It was developed to treat melanoma, and is still in trials for skin cancer, but the studies have shown mixed results and no one's been paying much attention to Ipilimumab. But the research team, headed by urologist Eugene Kwon, came up with a triple whammy protocol that perfectly exploits the antibody's primary function, which is to trigger an overwhelming immune system response.

Here's how it works: The men were given androgen hormone therapy to lower testosterone levels. This treatment, which is standard for many prostate cancer patients, leads to a surge in immune boosting T cells. Normally the body then flips the "off switch" on the production of T cells, preventing them from doing their work. But a single dose of the ipilimumab works as an antibody, stopping the off switch from being flipped. The result: The prostate tumor cells are swamped with an overwhelming immune system response, and die off.

The researchers described it as a "gasoline and pilot light approach." They used hormone therapy as the "pilot light" to ignite an immune response and then, after a short interval of hormone therapy, introduced Ipilumumab, the antibody, which acts like gasoline on the immune cells, igniting a firestorm that overwhelms the cancer cells.

In the trial, the two men's tumors -- both of which extended well beyond the prostate -- shrank so much they became candidates for surgery. And then, when the surgeons went in, the tumors were even smaller than they expected.

Normally I'd never write about a study that involved just two cases. But this news is dramatic and could be a life-saver for many, many men who have advanced inoperable prostate cancer, so I had to share it. The Mayo Clinic already has plans underway for extended trials to determine the correct dosages, optimize this therapy, and also to try to understand exactly how it works.

"This is one of the holy grails of prostate cancer," Kwon was quoted as saying. "This is what we've been seeking for years. Now we've got to build on this."

If someone I loved had a prostate tumor that wasn't a good candidate for surgery, I'd do everything I could to get him in this trial.