Drug for prostate cancer shows promise

In 2008, George Plemmons was told by doctors treating him for prostate cancer that he had, at most, a year and a half to live.

Then one of his physicians in his home state of Washington also shared something else with him: There was a clinical drug trial opening up soon at the Nevada Cancer Institute for men who had run out of conventional treatment options.

"I had made my peace with myself and with God, so I figured why not try it," Plemmons said.

Six months after Plemmons came to Las Vegas to take the experimental drug, doctors no longer could detect that he had any cancer.

"I remember jumping up and down when I heard the news," Plemmons' wife, Sharon, said as she sat inside the institute with her husband and his physician-researcher, Dr. Oscar Goodman Jr. "Never in my wildest dreams did I think that could happen."

What the Plemmonses talked about Tuesday in the most human terms, Goodman has helped relate in a scientific study published in the current issue of the prestigious New England Journal of Medicine.

That study, which he co-authored, found that the drug used at the Nevada Cancer Institute and 146 sites around the world resulted in a 35 percent increase in the overall survival of men with a form of prostate cancer that is largely unresponsive to current standards of care.

"This is what the Nevada Cancer Institute can be," an ecstatic Goodman said. "This is what we're supposed to be about."

Tuesday's news out of the institute was a far cry from the recent headlines made when half of the institute's staff was laid off in April as administrators try to manage $100 million in debt and stave off bankruptcy.

"We're still going to do clinical trials," Goodman said, acknowledging, however, that financial constraints do mean there will be fewer trials. "That's what we're about."

The drug that Plemmons has been on since May 2008 -- abiraterone acetate -- was first discovered in Great Britain . The treatment, approved by the Food and Drug Administration in April, has a brand name of Zytiga and is made by Johnson & Johnson.

The medicine targets a protein that plays an important role in the production of testosterone, which stimulates prostate cancer cells to grow. The drug works by decreasing the production of this hormone, essentially starving the tumor of the fuel it needs to grow.

"This drug holds great promise for the tens of thousands of men who are no longer responding to first-line chemotherapy and hormone therapies," Goodman said. "The drug not only prolongs overall survival for men living with this disease, but substantially improves the quality of their life during that time as well, with very few side effects."

Plemmons said the basic side effect he's experienced with the drug is fatigue.

More than 1,100 men participated in the study conducted in 13 countries. The patients were randomly assigned to receive either the experimental drug plus the steroid prednisone or placebo plus prednisone. The 797 patients who received the active drug lived on average 14.8 months compared with 10.9 months for those treated with placebo.

"We're hoping that in the near future we'll be able to give the drug to men earlier in their treatment, instead of when they're very advanced," Goodman said.

Goodman, the principal investigator of the drug at the institute, said Dr. Nicholas Vogelzang, the institute's former director who is now at Comprehensive Cancer Centers of Nevada, was instrumental in bringing the study to the institute.

Vogelzang said he has patients at Comprehensive who are doing well on the drug.

Twenty patients participated in the trial at the Nevada Cancer Institute, making it one of the largest contributors to the study.

Not all 20 patients have experienced the success of Plemmons.

"I wish they had," Goodman said. "He's in the top 1 percent of those who took the drug. We still have more research to do to find out just how this cancer acts."

Plemmons, who retired from work at an auto parts store, has traveled to Las Vegas once a month for more than two years to get checkups and his medication. Now that the FDA has approved the drug, that travel should stop.

"I'll be entering another phase of my life," he said.

He takes six pills a day plus a hormone-fighting injection every six months to keep the prostate cancer at bay.

"I see no reason to change what we've been doing now," Goodman said.

Only lung cancer is more fatal among men than prostate cancer, which kills 32,000 men each year. More than 215,000 men were diagnosed with prostate cancer in 2010.

Contact reporter Paul Harasim at pharasim@reviewjournal.com or 702-387-2908.