Analysis Shows Surgery to Remove Prostate Cancer that has Spread is Safe

New Brunswick, N.J., May 16, 2017 – An interim analysis of a phase I clinical trial examining a surgical procedure to remove the prostate and prostate cancer in men whose disease has spread (metastatic) shows the operation is safe and feasible in carefully selected patients. Investigators from Rutgers Cancer Institute of New Jersey presented the work as part of a podium presentation at the Annual Meeting of the American Urological Association taking place this week in Boston.

Androgen deprivation therapy, which lowers the level of hormones that cancer cells need to grow, is a standard treatment given for men with metastatic prostate cancer. Surgery to remove the cancer and the prostate (prostatectomy) is also common for localized disease but not for those who receive an initial diagnosis of metastatic prostate cancer. Little is known about the impact of this operation (cytoreductive prostatectomy) in these patients.

“Systemic therapy such as hormone therapy is effective at first for men with advanced or metastatic prostate cancer, but eventually the cancer becomes resistant to these drugs and they stop working. Surgery is typically not recommended for men with metastatic disease. Through our clinical trial we examined whether adding surgery to remove as much of the cancer as possible prior to administering hormone therapy and/or chemotherapy is better than or just as good as systemic therapy by itself,” explains Isaac Yi Kim, MD, PhD, chief of urologic oncology at Rutgers Cancer Institute and principal investigator of the study.

Data from 20 patients enrolled at Rutgers Cancer Institute and City of Hope in California were analyzed. The median age of patients at time of surgery was 62. Six patients had complications during the operation, with most (5) being minor. In men with a minimum six-month follow-up, 63.6 percent had a prostate specific antigen (PSA) level of less than 0.2 ng/ml suggesting that there may be a therapeutic benefit of removing the prostate in patients with metastatic disease.

“While our findings show this procedure is feasible and possibly beneficial for patients in this population, additional studies are needed to further define long-term complications and verify the benefits of removing metastatic disease in this way. We aim to further explore this in a phase 2.5 clinical trial currently under development at Rutgers Cancer Institute,” adds Dr. Kim, who is also an associate professor of medicine at Rutgers Robert Wood Johnson Medical School.

Along with Kim, other authors on the work include: Bertram Yuh, City of Hope; Young Suk Kwon, Brian Schinder, Sinae Kim, and Nara Lee, all Rutgers Cancer Institute; Nora Ruel, City of Hope; Shiego Horie, Juntendo University; Seok-Soo Byun, Seoul National Bundang Hospital; Dong Hyeon Lee, Ewha Woman’s University; and Robert DiPaola, University of Kentucky.