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News from the prostate cancer pharmaceutical industry

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Prostate cancer drugs are big business. It’s not ideal that companies profit from illness, but there are advantages to this situation. A large market for prostate cancer medicine means that these companies invest considerable resources into developing new drugs. The news coming from this industry can therefore tell us about the potential future treatments for men with prostate cancer.

Drug development by the pharmaceutical industry

The discovery and development of new medicines to treat cancers and the journey of these new drugs to market is a long and expensive process. It starts with drug discovery. This can come from laboratory research by grant-funded researchers, or from pharmaceutical companies that specifically look for drugs to fight tumours. The second step in the process is drug development. This includes pre-clinical studies in the laboratory, animal experiments, clinical trials in humans and regulatory processes. Patent applications are an important part of this process. The development of new drugs takes about 8 to 10 years and costs close to 1 billion dollars.

This situation is far from ideal. The huge cost involved in developing a new drug and bringing it to market means that the prices of these new drugs are extremely high. In Australia, we are fortunate that the Pharmaceutical Benefits Scheme (PBS) subsidises most essential new drugs, making them affordable. Unfortunately, it takes a considerable amount of time for these new drugs to become available and affordable in Australia.

Profit from cancer drugs

Companies will usually choose drugs that are highly profitable, aiming to make money in the long run. Profits from a successful drug are usually used to fund the development of the next drug. Many new drugs do not make it past the trials and regulatory processes to get to the market. So numerous different new drugs must start development in order to ensure success from the 1 or 2 that eventually become highly profitable.

This is a terrible system for rare diseases, as drugs for these diseases won’t make much profit. But it works well for common diseases such as prostate cancer. The relatively large number of men diagnosed with this cancer means a large market for these drugs. Prostate cancer drugs are usually highly profitable, so they are more likely to be developed. This is one of the reasons why we have seen so many new drugs for this cancer become available in the past 10 years. Meanwhile, people with rare cancers have few treatments from which to choose.

News from the pharmaceutical industry

The news coming from the pharmaceutical industry can tell us about the upcoming new treatments for men with prostate cancer. Here are three recent announcements:

  1. Australian company Noxopharm report promising results from an early trial of Veyonda

Veyonda is a drug that is being developed by an Australian company called Noxopharm. Noxopharm hope that Veyonda will make other prostate cancer treatments more effective. Veyonda targets an enzyme that is vital to the growth of cancer cells. Treatment with Veyonda aims to leave the cancer cells highly vulnerable to other treatments such as radiotherapy and chemotherapy.

Noxopharm have announced promising results from their pilot trial of Veyonda combined with radiotherapy for men with late-stage advanced prostate cancer. The combined treatment led to some reductions in tumour size, pain and PSA levels. In this small trial, 11 men tried the treatment, with two of them experiencing a significant reduction in tumour size. Larger trials of this combination treatment are required to provide firm evidence of the benefits of Veyonda for men with advanced prostate cancer.

  1. Early results from a small trial testing Onvansertib

Onvansertib is a drug that inhibits the activity of an enzyme called PLK1. PLK1 exerts control over cell division – the process by which cells increase in number. Cell division is often problematic in cancer, leading to the production of too many cells. We see too much PLK1 made by some types of tumours. These extra PLK1 enzymes are driving cell division creating too many cells. The US company Trovagene Oncology are trialling Onvansertib for the treatment of acute myeloid leukemia, colorectal cancer and prostate cancer.

Results from a phase 2 clinical trial testing Onvansertib for men with metastatic castration resistant prostate cancer were recently announced at the 2019 APCC conference. This small trial combined Onvansertib with Abiraterone (Zytiga) for 12 weeks of treatment. They tested the PSA response and visibility of tumours on scans after this combination treatment. So far, 12 men have completed the treatment, but the study is ongoing.   

Three of the men in this trial have seen their PSA levels drop considerably. Each of these men had positive tests for a biomarker called AR-V7. AR-V7 is a mutated form of the androgen receptor (AR). This androgen receptor tells the tumour cells to divide when it recognises the presence of hormones such as testosterone. The AR-V7 form of this receptor is found in men whose prostate cancer is aggressive and often resistant to current treatments. The results from this trial indicate that Onvansertib could be an effective treatment for this aggressive prostate cancer. Larger trials are needed to confirm this preliminary finding.

  1. CT7001, an experimental drug, will be trialled for prostate cancer in the UK and US

When metastatic prostate cancer becomes resistant to hormone therapies, it can sometimes grow in the absence of testosterone. This happens through the actions of the androgen receptor. But it doesn’t work alone. This receptor affects a cascade of molecular events that culminate in cell division. One of the molecules in this pathway is a protein called Med1. The androgen receptors switches this protein on, leading to cell division.

A new drug, currently called CT7001, can switch off Med1. Switching off Med1 cuts off the events downstream of the androgen receptor. This is an alternative approach that can be used once turning off access to hormones no longer works.

Similar drugs to CT7001 are already being tested for other types of cancer, such as breast cancer and acute myeloid leukemia.

CT7001 has been licensed to Carrick Therapeutics, an UK company from Oxford. Carrick Therapeutics have started a trial to test CT7001 for breast cancer. A second part of this clinical trial will test whether CT7001 benefits men with prostate cancer. Their plan is to treat up to 25 men with castration-resistant prostate cancer with a daily dose of CT7001. They will test the safety of the new drug as well as its effects on PSA and tumours on scans. The trial will recruit men from the UK and the US.

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