Prostate cancer is one of the most common cancers affecting men, with over a million diagnoses worldwide each year. Surgery to remove the prostate, called a radical prostatectomy, is a standard, essential part of treatment. However, if you or a loved one has been diagnosed with unfavorable intermediate-risk or high-risk localized prostate cancer, then you may know that even after surgery, significant concern remains about cancer returning.
But, what if there was a brand new approach that could redefine treatment strategies, improve survival rates, and give men better long-term outcomes? What if there was an approach that could increase the effectiveness of surgery and reduce the risk of recurrence? Well, this is exactly what the NePtune study aims to do.
Generally, men with specific genetic mutations that affect the body’s ability to repair DNA – such as ATM, BARD1, BRCA1, BRCA2, BRIP1, CHEK2, CDK12, FANCA, PALB2, RAD51C, RAD51D, and RAD54L2 – undergo a radical prostatectomy without any systemic treatment prior, such as hormone therapy, chemotherapy, immunotherapy, or androgen deprivation therapy. These mutations allow cancer to grow more aggressively, oftentimes making cancer recurrence a major concern. The NePtune study explores a new, alternative approach: administering treatment before surgery to preemptively weaken the cancer, rather than waiting until after it returns to treat it.
This study focuses on combining a targeted therapy called olaparib, a PARP inhibitor, with a hormone therapy known as luteinizing hormone-release hormone (LHRH) agonist. Olaparib works by disrupting cancer cells’ ability to repair themselves, while LHRH agonists lower testosterone levels to slow cancer growth. The goal is to see whether this combination can reduce the amount of disease present at the time of surgery, lowering the chances of recurrence and keeping the cancer inactive for a longer period.
If this approach shows added benefit, it could help to reshape the landscape of prostate cancer treatment. Neoadjuvant therapy, treatment given before surgery, is already used effectively in other types of cancer, including breast cancer, and its introduction into prostate cancer treatment could be a major advancement. Instead of relying on surgery alone, this approach could lead to better outcomes and improved quality of life for patients facing prostate cancer.
Dr. Rana McKay, the lead investigator of this study, said, “The NePtune study represents a paradigm shift in how we approach high-risk prostate cancer treatment. By combining targeted PARP inhibition with hormone therapy before surgery, we're attacking the cancer at a vulnerable stage rather than waiting for recurrence. For men with DNA repair mutations, this approach could significantly reduce tumor burden prior to surgery and potentially improve long-term outcomes, bringing us closer to what we all want - a cure. We're not just treating cancer—we're redefining the treatment timeline to give patients their best chance at a cancer-free future.”
By participating in the NePtune study, men facing this challenging diagnosis could not only explore a potentially more effective treatment for themselves but also contribute to research that may change prostate cancer care for future generations. If you or a loved one has been diagnosed, enrolling in this study could be an opportunity to take a proactive step in your treatment journey.
Learn more about the NePtune study here.