Checkmate for prostate cancer

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.

This form of cancer occurs in the prostate, which is 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, according to the Mayo Clinic.

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.

In Stuart’s case, 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,” Austine Stuart said, Ralph’s wife.

Ralph’s doctors tried hormone treatment but his cancer kept spreading. That is 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,” Austine said.

Patients in the trial receive an IV infusion of two drugs that boost the immune system: ipilimumab and nivolumab.

“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,” Akash Patnaik, MD, PhD, an Oncologist from the University of Chicago said.

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,” Dr. Patnaik said.

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.

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 said.

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.