Below the Belt Award

 Megan Crumbaker — 2021

A Phase II study of high dose testosterone in combination with carboplatin in men with metastatic castrate-resistant prostate cancer
Prostate cancer that has spread beyond the prostate and its nearby areas is usually incurable and targeted with treatment that lowers testosterone, called ADT. ADT is associated with several side effects, including some that worsen over time on treatment. Though effective initially, prostate cancers generally become resistant to ADT eventually. This resistance allows the cancer to grow, causing symptoms, such as pain, and shortened lifespan. Research shows that prostate cancer cells in the lab can adapt to ADT in ways that make them vulnerable to attack from high testosterone levels. Recent prostate cancer trials used pulses of testosterone in men with ADT-resistant cancer to try to shrink the cancer and improve men’s overall wellbeing. The research found that the treatment is safe, associated with improved quality of life and has anti-cancer effects. Based on this research and other research into the effect of testosterone on resistant prostate cancer cells, we hypothesise that adding a particular chemotherapy drug, carboplatin, will enhance the effectiveness of testosterone treatment without compromising quality of life. We have treated 9 men with the combination of testosterone and carboplatin. Many of the patients on this pilot study report feeling much better due to an increase in their testosterone levels. The treatment has also stopped the growth of some men’s cancer. We would like to use funding from this grant to expand the study to other cancer centres to improve access to this novel treatment, assess the effectiveness of the treatment, and determine whether a larger trial comparing it against other prostate cancer treatments would be worthwhile.