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WINGMEN: Windows trial of INsulin-like Growth factor neutralising antibody Xentuzumab in MEN scheduled for radical prostatectomy

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Primary Publication

Pending

Lay Summary

The WINGMEN trial aim was to understand how a protein similar to a hormone - insulin-like growth factor (IGF) - helps prostate cancers grow and become aggressive, making them more difficult to treat. IGF is required for normal development, but also helps cancers grow and spread. People with high levels of blood IGF are at increased risk of developing some cancers, including prostate cancer.

The WINGMEN trial recruited people with prostate cancer who had been offered an operation to remove the prostate. Most patients have to wait 4-5 weeks between a decision to have prostate removal surgery, and actually having the operation. In this window the WINGMEN patients were given treatment with an IGF-blocker drug called xentuzumab. Xentuzumab was given once weekly, by intravenous infusion (drip) in the Churchill Hospital, Oxford. Some patients had to wait a bit longer for their surgery and continued to receive weekly treatment throughout this time.

Samples of blood and tumour were taken both before patients received treatment with xentuzumab and after surgery. These samples were compared to measure how effectively xentuzumab reduces signs of tumour growth. They were also tested to identify which genes are switched on or off in cancer cells by xentuzumab, and which may therefore be important in understanding how IGF promotes prostate cancer growth.

27 patients took part in WINGMEN. 26 went on to have the operation to remove the prostate. The main analysis of the prostate samples showed significant reduction in IGF following treatment with xentuzumab. Furthermore, none of the patients had severe side effects to xentuzumab.  

Additional tests on the blood and prostate samples are ongoing. Information from these tests will help us to determine how to improve treatment of men with prostate cancer, with the long-term aim of reducing the risk of aggressive prostate cancer. The WINGMEN study has provided, and will provide, a great deal of information regards the effects on cancer biology of targeting the insulin growth factor. This will help us understand how we might develop future drugs that target this hormone, including how we can select patients and combine with other cancer treatments.