Life – Terror. Ecstasy. Fight. Denial. Flight. Failure. PAIN. Forgiveness. Reconciliation. Hope. Love. Peace – Death
The immune system is able to kill cells that are harming the body, including cancer cells. However, cancer can often turn off the body’s natural ‘anti-cancer immune responses’. One way in which our scientists are trying to defeat cancer is by reawakening the immune system, encouraging immune cells to attack cancer cells.
Immunotherapy is a type of treatment that has been very effective in other cancers, including skin cancer, but we are just beginning to make it work for men with prostate cancer.
However, investigating the immune response in prostate cancer is already starting to show promise. Professor Johann de Bono has been working to understand and target a protein known as CD38, displayed on the surface of immune cells. He will soon be leading a clinical trial in this area, which is a first in prostate cancer – looking at drugs which target CD38, which could hold promise against prostate cancer by reawakening the anti-cancer immune response and fighting cancer’s ‘cloaking’ strategy, which allows it to hide from the immune system.
Another trial looking at an immunotherapy showed that some men with advanced prostate cancer with mutations in genes involved in DNA repair, like the BRCA genes, and who had exhausted all other treatment options could live for two years or more on the immunotherapy pembrolizumab.
Manipulating ‘gut bugs’
More and more evidence is showing that the microbiome – the community of microorganisms living in and on us, which are essential to our development and immunity – plays a role in many diseases, including prostate cancer.
Recently, Professor de Bono and his team found that common gut bacteria can become ‘hormone factories’ and sustain prostate cancer’s growth, progression and resistance to hormone therapy – opening up a whole new research avenue.
In future we might see bacterial ‘fingerprints’ used in the clinic to pick out patients at high risk of developing resistance to treatment. These patients could then benefit from strategies to manipulate their microbiome – for example, men could undergo faecal transplants to alter their intestinal microbiota, reducing the number of certain potentially harmful bacterial strains.
Ultimately, researchers hope to come up with a yoghurt drink enriched with bacteria that could also switch the microbiome to a more favourable profile and avoid or delay resistance to hormone treatments.
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