癌症研究突破---前列腺癌

為什麼hc將這則放在這blog
因為 Deming 是前列腺癌過逝的 1900-93)




癌症研究突破 《每日郵報》的頭版報道了英國科學家在治療癌症方面取得了突破。 報道說，對前列腺癌的治療不需要化療。試驗顯示一種新的藥物在80%的案例中能縮小腫瘤，無需使用化療或理療。 報道援引專家說。這項研究結果可能是前列腺癌研究領域幾十年來的最大突破，能夠挽回成千上萬的生命。科學家相信這種技術還能應用於其它癌症，例如乳腺癌和膀胱癌。

英國研究人員表示，一天服用一次阿比特龍（abiraterone）可使末期攝護腺癌的腫瘤大幅縮小，平均延緩病情惡化的時間達四百天。這也可能是七十年來治療攝護腺癌最大的突破。

主持這項實驗的英國癌症研究所研究員波諾表示：「我們認為，這種藥物非常有效，藥效持久。」阿比特龍是由柯嘉生技公司（Cougar Biotechnology）研製，第一階段的臨床實驗結果已經透過《臨床腫瘤學期刊》（Journal of Clinical Oncology）發表。

部分研究人員認為，腫瘤組織能夠自製助長病情所需的雄性荷爾蒙。波諾表示：「這些荷爾蒙使癌細胞得以存活；阿比特龍可使腫瘤無法製造荷爾蒙。」代號 CYP17的酵素在腫瘤製造荷爾蒙過程中扮演關鍵角色，阿比特龍能夠加以鎖定。此外，即使癌細胞已經擴散，阿比特龍還是可以發揮效果。

許多末期病患接受其他療法後，病情毫無起色。在臨床實驗過程中，大約七到八成志願者服用阿比特龍之後，攝護腺特異抗原濃度降低，腫瘤明顯縮小，生活品質改善。

研究人員指出，部分志願者服用阿比特龍已經兩年半，不但病情獲得控制，副作用也低。主要的副作用包括倦怠與體重降低。

阿比特龍已經進入第三階段臨床實驗，研究人員希望它能夠在三年後問世。部分專家則持保留態度。

攝護腺癌是僅次於肺癌的男性第二大殺手，全球各地每年新增病例平均約六十八萬例，大約廿二萬人不治。如果化療與放療無法改善病情，病人的存活期平均約僅一年到一年半。波諾指出，全球約有兩百五十名末期病患接受阿比特龍新藥治療，有些已經活了兩年八個月。

另一位癌症專家希柯拉表示，「癌症仍是絕症，但我們可以幫助癌末病患活下去，通常罹患癌症者已逾六十歲，如果能讓他們多活十到十五年也很不錯。」

The prostate cancer 'wonder pill' set to save thousands every year

By Daniel Martin
Last updated at 7:54 AM on 22nd July 2008

'Wonder drug': Lead researcher Dr Johann de Bono hopes abiraterone will be available for general use by 2011

British researchers have made a dramatic breakthrough against a lethal form of prostate cancer.

Trials of a new pill have shown that it can shrink tumours in up to 80 per cent of cases, and end the need for damaging chemotherapy and radiotherapy.

Experts hailed the advance as potentially the biggest in the field of prostate cancer for decades, capable of saving many thousands of lives.

Scientists believe the technique could also be effective on other tumours, such as breast and bowel cancers.

The drug, abiraterone, was discovered by researchers at the Royal Marsden Hospital in South-West London.

Their leader, Dr Johann de Bono, said patients there had been able to control the disease with just four pills a day and very few side-effects.

Prostate cancer is Britain's most common cancer among men and the second highest killer, after lung cancer. Some 35,000 people a year are diagnosed with it - and 12,000 die.

There are two types, aggressive and non-aggressive, which are often called 'tiger' and 'pussycat'. Men with pussycat cancer can often lead a healthy life, but the tiger variety - a third of cases - is usually fatal within 18 months.

Hormone therapy, the standard method of treating prostate cancer, involves blocking production of male hormones like testosterone, which 'feed' the tumour. But it can be ineffective on aggressive forms.

If it fails, doctors turn to chemotherapy, which can have severe side-effects such as nausea, pain, malnutrition, haemorrhages and hair loss.

Many patients also have radiotherapy, to reduce associated pain in the bones. This can be dangerous too, damaging organs and leaving patients exhausted and with little quality of life.

Abiraterone uses a different approach, blocking chemicals in the body which help in the production of the male hormones. It is expected to be widely available in three years, but until then can be obtained only as part of clinical trials.

John Neate, chief executive of the Prostate Cancer Charity, said: 'This is an exciting development which has been eagerly anticipated. Advanced prostate cancer is very difficult to treat as, after time, it stops responding to conventional ways of controlling the male hormone.

'We look forward to the results of the larger trials already under way or being planned for this drug to prove its potential effectiveness.'

Previous hormone therapy had been directed at stopping the production of male hormones in the testes. This works for only about a quarter of aggressive cancer cases, however, and most scientists had written off hormones as a target for research.

But the Royal Marsden team ignored the doubters through 15 years of painstaking study.

The breakthrough came when they found that sometimes the tumour itself can produce hormones - meaning that new treatment needed to target hormones anywhere in the body.

They decided to aim at a key enzyme which is needed for the hormones to be produced.

The Royal Marsden Hospital where the pioneering research was carried out

Experiments with tumour cells in the Royal Marsden's state-of-the art laboratories - the base of Britain's Institute of Cancer Research and Europe's largest cancer research centre - eventually came up with abiraterone.

Studies on 100 patients at the hospital and 150 more in the U.S. have shown that in more than three quarters of cases, the tumour shrunk.

Most men experienced far less pain, meaning radiotherapy could become a thing of the past.

Maltese-born Dr de Bono, 41, who came to Britain in 1984, said last night: 'The Royal Marsden patients have been monitored for up to two and a half years and with continued use of abiraterone they were able to control their disease with few side-effects.

'The drug works even if the cancer has spread beyond the prostate, such as to the bone.

'These men have very aggressive prostate cancer which is exceptionally difficult to treat and almost always proves to be fatal. We hope that abiraterone will eventually offer them real hope of an effective way of managing their condition and prolonging their lives. My vision is to make chemotherapy obsolete.'

Dr de Bono said patients should ask their consultant for details about getting on one of the clinical trials.

As the drug is newly in development, it is not yet known how many years' extra survival it can bring. But patients on the trial have so far lived longer than the estimated 12 or 18 months.

Prostate cancer is associated with ageing, and over the next 25 years it is estimated there will be a 60 per cent increase in the number of men over 65. This means there will be more cases of the cancer and abiraterone could save many thousands of lives.

Its side-effects can include loss of libido, breathlessness, fatigue, fluid retention and weight gain. Some men may be left impotent, but the effects are far less than with chemotherapy and radiotherapy.

Abiraterone is now being used in a 1,200-patient international study, including at ten sites across the UK. If it is licensed as expected in 2011, it will have to await approval by the rationing watchdog NICE before it is made freely available across the NHS.

Dr de Bono describes prostate cancer as the 'Cinderella cancer' because it receives just a quarter of the funding of breast cancer - £10million against £40million last year - even though it kills just as many people.