Nerve-Protecting Drugs May Help Men Recover Potency Sooner
Two men have "ideal" prostate cancer scenarios: Both are fairly young, in their late fifties, both have cancer that's detected early, when it is well within the prostate, and both undergo radical prostatectomy. And yet -one man recovers potency within six months; the other takes more than a year. Why?
Nobody knows for sure. The nerves that are responsible for erection have three strikes against them with any form of treatment for prostate cancer: They're tiny, very frail, and unless the surgery to preserve them, while removing the cancer, is performed flawlessly, they're right in the line of fire - they run in microscopic bundles along both sides of the prostate.
In pioneering laboratory research several years ago, Arthur L. Burnett II, M.D., professor of urology, discovered that solutions using special proteins called immunophilinligands helped rats with nerve injury and erectile dysfunction (similar to that found in men after radical prostatectomy) recover penile nerve function. The immunophilinligands, and eventually, a prototype drugcalled GPI1485, seemed to soothe, protect, invigorate these nerves - and even to help them repair themselves - resulting in stronger erections, recovered earlier, and dramatically less nerve damage. The results were so promising that GPI1485 was tested
in clinical trials, given orally to men undergoing radical prostatectomy who had both nerve bundles spared.
The latest Hopkins-led trial, involving 196 men in 23 hospitals, is nearing completion, says Burnett. "This is a Phase II investigation. Our overall objective is to determine whether the drugs can speed up and improve the process - whether erectile function recovery is achieved faster and better with treatment than with nerve preservation alone." Men in the study are monitored up to a year, not only for erectile function, but for health-related quality of life issues, and to make certain that the drug is safe. "Our early impressions are that the treatment has been well tolerated, without major side effects," says Burnett. "We will determine how successful this has been, and report on it by early 2006."