Cancer: shock breakthrough

Patients with inoperable prostate disease recover after single dose of drug

Two patients with inoperable prostate cancer have made dramatic recoveries after receiving one dose of an experimental drug that is creating excitement among cancer specialists.

The results were so startling that researchers decided to release details of the two cases before the drug trial – in which the patients took part – was complete. Doctors said their progress had exceeded all expectations. The men were treated at the Mayo Clinic in Minnesota in the US, one of the top medical centres in the world.

Dr Eugene Kwon, the urologist who was in charge of their treatment, compared the results to the first pilot breaking the sound barrier.

"This is one of the Holy Grails of prostate cancer research. We have been looking for this for years," he said.

Prostate cancer is the most common cancer in men – 34,000 new cases and more than 10,000 deaths are reported each year in Britain, where rates of its occurrence have tripled in the past 30 years, mainly due to improved detection. The US has the highest incidence of the disease.

Rodger Nelson and Fructuoso Solano-Revuelta were diagnosed with advanced prostate cancer and sought treatment at the Mayo Clinic.

They were told the disease had spread beyond the prostate. Mr Nelson's cancer was encroaching on the abdomen and Mr Solano-Revuelta's tumour was the size of a golf ball. Patients in such condition are told they may have only months to live, and are normally only offered palliative care. But after one infusion of the drug ipilimumab, a monoclonal antibody that stimulates the immune system, given with conventional hormone therapy, their tumours shrank enough to be surgically removed. Both men have since made a full recovery and returned to their businesses.

The pair were part of a trial involving 108 patients, half of whom received the experimental drug. The trial is ongoing but the improvement of the two patients was so dramatic and unexpected that they were removed from the study so they could undergo curative surgery.

Dr Kwon said yesterday: "Halfway through the trial we began seeing remarkable responses. Some patients had dramatic shrinkage of their tumours so practically all traces had disappeared. We had thought we might get some incremental delay in the progression of the cancer. It had not dawned on us that we might go from an inoperable tumour to an operable one. That just doesn't happen."

The surgery would not have gone ahead if Carol Nelson, Mr Nelson's wife and a former nurse, had not challenged the surgeons to attempt it.

"The idea of surgery on an 'inoperable' tumour had not dawned on us. It is often disappointing and not advisable. But she is a tough lady – and having been a nurse she knew how to control the doctors. We said we didn't think surgery would work, but we would try," Dr Kwon said.

The outcome was better than any of them could have anticipated. From having an enlarged prostate gland riddled with cancer which had spread, Mr Nelson was found to have a shrunk prostate gland with tiny pockets of cancer that were "very hard to find".

Michael Blute, the surgeon who operated on Mr Nelson, said at one point doctors feared they might have the wrong patient: "I was cutting away scar tissue trying to find cancer cells. The pathologist was checking samples as we proceeded and sent word back asking if we had the right patient. He had a hard time finding any cancer. I have never seen anything like this before. The pathologists were floored."

The procedure was repeated, with the same result, on Mr Solano-Revuelta. A third "inoperable" patient underwent surgery last week.

Dr Kwon said: "These were patients for whom there was no hope. The course of their disease has been altered in a dramatic fashion. We have a major finding which we never expected to stumble across but we have to complete our studies."

He said the findings had to be confirmed in further studies and the results published in a peer-reviewed journal. A larger trial is due to begin in the autumn. The cases are described in the Mayo Clinic's research publication, Discovery's Edge.

Professor Malcolm Mason, a Cancer Research UK prostate cancer specialist, said: "These case reports are extremely interesting and encouraging. Ipilimumab might potentially be a strong stimulator of the immune system, and it seems logical that it might also be effective in prostate cancer.

"But caution is needed, as earlier trials with this drug in other types of cancer were less successful than reported here, and its true value can only become clear through large-scale, randomised clinical trials, two of which are already under way. The other cautionary note is that both men received hormone therapy, which in some instances causes dramatic reductions in tumour size by itself."

Ipilimumab: How it works

*Ipilimumab is one of a class of drugs called monoclonal antibodies, which stimulate the body's own immune system to fight disease. The experimental treatment is being developed by Bristol-Myers Squibb and Medarex, a US biotech company. The drug is being trialled on malignant melanoma, the most serious form of skin cancer, Hodgkin's disease, lung cancer and prostate cancer. Studies are most advanced in melanoma, where it has been shown to prolong survival in patients with advanced forms of the disease. In the Mayo Clinic study of prostate cancer, researchers say that standard hormone treatment ignited the immune response, and adding ipilimumab was like "pouring gasoline on the pilot light".

News
Jennifer Lawrence was among the stars allegedly hacked
peopleActress and 100 others on 'master list' after massive hack
Sport
Radamel Falcao
footballManchester United agree loan deal for Monaco striker Falcao
Sport
Louis van Gaal, Radamel Falcao, Arturo Vidal, Mats Hummels and Javier Hernandez
footballFalcao, Hernandez, Welbeck and every deal live as it happens
Sport
footballFeaturing Bart Simpson
PROMOTED VIDEO
Life and Style
ebooksA superb mix of recipes serving up the freshest of local produce in a delicious range of styles
Life and Style
ebooksFrom the lifespan of a slug to the distance to the Sun: answers to 500 questions from readers
News
people'It can last and it's terrifying'
Voices
A man shoots at targets depicting a portrait of Russian President Vladimir Putin, in a shooting range in the center of the western Ukrainian city of Lviv
voicesIt's cowardice to pretend this is anything other than an invasion
News
i100
Arts and Entertainment
Alex Kapranos of Franz Ferdinand performs live
music Pro-independence show to take place four days before vote
Arts and Entertainment
booksNovelist takes aim at Orwell's rules for writing plain English
Arts and Entertainment
The eyes have it: Kate Bush
music
Latest stories from i100
Have you tried new the Independent Digital Edition apps?

ES Rentals

    Independent Dating
    and  

    By clicking 'Search' you
    are agreeing to our
    Terms of Use.

    iJobs Job Widget
    iJobs General

    PPC Co-Ordinator – Permanent - West Sussex – £24-£30k

    £24000 - £30000 Per Annum: Clearwater People Solutions Ltd: Are you a Marketin...

    Cover Supervisors - WE NEED YOU!

    £70 - £90 per day: Randstad Education Hull: Randstad Education have cover supe...

    Senior Asset Manager

    £70000 - £75000 Per Annum: The Green Recruitment Company: Katie Robinson +44 (...

    SEN British Sign Language Teacher

    Negotiable: Randstad Education Birmingham: BSL teachers required to teach in a...

    Day In a Page

    Alexander Fury: The designer names to look for at fashion week this season

    The big names to look for this fashion week

    This week, designers begin to show their spring 2015 collections in New York
    Will Self: 'I like Orwell's writing as much as the next talented mediocrity'

    'I like Orwell's writing as much as the next talented mediocrity'

    Will Self takes aim at Orwell's rules for writing plain English
    Meet Afghanistan's middle-class paint-ballers

    Meet Afghanistan's middle-class paint-ballers

    Toy guns proving a popular diversion in a country flooded with the real thing
    Al Pacino wows Venice

    Al Pacino wows Venice

    Ham among the brilliance as actor premieres two films at festival
    Neil Lawson Baker interview: ‘I’ve gained so much from art. It’s only right to give something back’.

    Neil Lawson Baker interview

    ‘I’ve gained so much from art. It’s only right to give something back’.
    The other Mugabe who is lining up for the Zimbabwean presidency

    The other Mugabe who is lining up for the Zimbabwean presidency

    Wife of President Robert Mugabe appears to have her sights set on succeeding her husband
    The model of a gadget launch: Cultivate an atmosphere of mystery and excitement to sell stuff people didn't realise they needed

    The model for a gadget launch

    Cultivate an atmosphere of mystery and excitement to sell stuff people didn't realise they needed
    Alice Roberts: She's done pretty well, for a boffin without a beard

    She's done pretty well, for a boffin without a beard

    Alice Roberts talks about her new book on evolution - and why her early TV work drew flak from (mostly male) colleagues
    Get well soon, Joan Rivers - an inspiration, whether she likes it or not

    Get well soon, Joan Rivers

    She is awful. But she's also wonderful, not in spite of but because of the fact she's forever saying appalling things, argues Ellen E Jones
    Doctor Who Into the Dalek review: A classic sci-fi adventure with all the spectacle of a blockbuster

    A fresh take on an old foe

    Doctor Who Into the Dalek more than compensated for last week's nonsensical offering
    Fashion walks away from the celebrity runway show

    Fashion walks away from the celebrity runway show

    As the collections start, fashion editor Alexander Fury finds video and the internet are proving more attractive
    Meet the stars of TV's Wolf Hall... and it's not the cast of the Tudor trilogy

    Meet the stars of TV's Wolf Hall...

    ... and it's not the cast of the Tudor trilogy
    Weekend at the Asylum: Europe's biggest steampunk convention heads to Lincoln

    Europe's biggest steampunk convention

    Jake Wallis Simons discovers how Victorian ray guns and the martial art of biscuit dunking are precisely what the 21st century needs
    Don't swallow the tripe – a user's guide to weasel words

    Don't swallow the tripe – a user's guide to weasel words

    Lying is dangerous and unnecessary. A new book explains the strategies needed to avoid it. John Rentoul on the art of 'uncommunication'
    Daddy, who was Richard Attenborough? Was the beloved thespian the last of the cross-generation stars?

    Daddy, who was Richard Attenborough?

    The atomisation of culture means that few of those we regard as stars are universally loved any more, says DJ Taylor