In a study of more than 400 men with localized prostate cancer, researchers reveal that the new treatment - called vascular-targeted photodynamic therapy (VTP) - can kill prostate cancer cells, without damaging the healthy surrounding tissue. Furthermore, VTP was found to significantly reduce the need for radical therapy, such as the removal or irradiation of the entire prostate.
Lead investigator Prof. Mark Emberton, dean of medical sciences and a consultant urologist at University College London in the United Kingdom, and colleagues recently reported their findings in The Lancet Oncology. After skin cancer, prostate cancer is the most common cancer in men in the United States, with around 180,890 new cases expected to have been diagnosed in 2016.
For men with localized prostate cancer - cancer that is considered low risk and has not spread beyond the prostate - "active surveillance" is often the first port of call. This is where the cancer is closely monitored through prostate-specific antigen (PSA) tests, digital rectal exams, or prostate biopsies, and it is only treated if it becomes more severe.
If the cancer does worsen, treatment may involve radical prostatectomy - which is the surgical removal of the prostate and nearby tissues - or radiation therapy. These procedures can pose a number of side effects, including bowel issues, urinary incontinence, and lifelong erectile dysfunction.
However, Prof. Emberton and colleagues suggest that VTP could reduce the need for such treatments by combatting prostate cancer in its early stages.
Complete remission for 49 percent of VTP-treated men
VTP was developed by researchers from the Weizmann Institute of Science in Isreal, in collaboration with biotechnology company STEBA Biotech.
The treatment involves the injection of a light-sensitive drug called WST11 - derived from bacteria found at the bottom of the ocean - into the bloodstream. Upon activation with a laser, the drug releases free radicals that destroy cancer cells in the prostate. For their phase III trial, Prof. Emberton and colleagues enrolled 413 men from 47 treatment sites across 10 European countries, all of whom had been diagnosed with early localized prostate cancer and were under active surveillance.
Of these patients, 206 were randomized to receive VTP, while the remaining 207 patients continued with active surveillance (the control group). Patients were followed-up for 2 years, undergoing PSA testing and assessment of urinary and erectile functions every 3 months, as well as prostate biopsies at 12 and 24 months.
At the end of the 2-year follow-up, the researchers found that 49 percent of patients treated with VTP had entered complete remission, compared with only 13.5 percent of patients who received active surveillance.
Additionally, the researchers found that only 6 percent of men treated with VTP required radical therapy, compared with 30 percent of men in the control group. The team also reports that VTP-treated patients were three times less likely to have their cancer progress, and VTP was found to double the average time to progression from 14 months to 28 months.
Noting the side effects of VTP, the researchers report that some men experienced urinary and erectile problems, but these resolved within 3 months of treatment initiation. At 2 years, no significant side effects were present.
'Excellent news' for men with localized prostate cancer
The researchers believe that the findings of their phase III trial indicate that VTP is a promising nonsurgical approach to the treatment of localized prostate cancer.
"These results are excellent news for men with early localized prostate cancer, offering a treatment that can kill cancer without removing or destroying the prostate," notes Prof. Emberton.
By: Honor Whiteman
Medical news today
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