As a chemical engineer, John Frotton, 66, was always about the numbers. His work involved sophiscated projects converting waste streams into new forms of energy.
Last year, however, numbers took on an entirely new meaning for Frotton following a routine prostate screening. His test measures for Prostate-Specific Antigen (PSA) shot up from 3 to 9 in less than a year.
A protein made by the prostate gland to help detect prostate cancer, high PSA levels can indicate prostate cancer. But higher numbers can also point to benign conditions, such as an enlarged prostate (BPH) or prostatitis.
What is a PSA Test?
A PSA test is a key marker for prostate health and is a screening tool for early detection, but it is not a definitive diagnosis. It is often used in conjunction with a digital rectal exam (DRE) and other tests, all part of a shared decision-making process with a doctor, Hackensack Meridian Health said.
In Frotton’s case, his PSA had always been a very normal under 3. But in less than a year, his 3 shot up to 9. The diagnosis that followed was one that millions of men fear: aggressive prostate cancer.
“Aggressive” is a shocking word no one wants to hear when it comes to test results, especially when cancer is a concern. In his case, the standard treatment plan was clear and immediate: a radical prostatectomy to surgically remove the prostate and some surrounding lymph nodes.
Trial Treatments At The Ready
For men with high-risk cancer, the chance of the disease returning can be as high as 40% in 10 years or less. It’s a statistc that can weigh heavily on a patient’s mind, HMH said. Even with the best surgery, a shadow of uncertainty often remains.
This is where Frotton’s story takes a pioneering turn. He was offered a chance to fight the cancer before it was even removed. He became the very first patient to enroll in the PRELUDE Trial, a groundbreaking clinical study aimed at preventing recurrence.
The Trial at the John Theurer Cancer Center
Led by Dr. Nitin Yerram, co-director of urologic oncology at the renowned John Theurer Cancer Center (JTCC), the trial represents a paradigm shift in treatment.
“We are dedicated to advancing the treatment of prostate cancer and proud to be the first center in North America to conduct this innovative clinical trial,” said Dr. Yerram.
Executing such a sophisticated treatment requires a seamless, multidisciplinary approach. For the PRELUDE trial, this means a dedicated team of specialists from Urologic Oncology, Nuclear Medicine, and Radiation Oncology work in close collaboration.
The nuclear medicine team is responsible for the precise preparation and administration of the radiopharmaceutical, while radiation oncologists provide expertise on its therapeutic effects.
This integrated effort is so specialized that Hackensack University Medical Center is currently the only institution where urologists can offer patients this proactive treatment, solidifying its position as a leader in prostate cancer care.
‘… a microscopic heat-seeking missile’
The PRELUDE Trial is testing a powerful, FDA-approved therapy called Lu-177-PSMA-617 in a new way. Instead of being used for cancer that has already spread, it’s being given to men like John before their surgery.
Think of it as a microscopic heat-seeking missile.
The therapy contains two parts: a molecule that targets a protein (PSMA) found almost exclusively on prostate cancer cells, and a radioactive particle (Lu-177) that delivers a precise dose of radiation. The drug travels through the body, locks onto the cancer cells, and destroys them, while minimizing harm to healthy tissue.
The goal is to eliminate any microscopic cells that might have escaped the prostate, effectively stopping a recurrence before it can even start.
The First Patient
As the first participant, Frotton’s received two cycles of the therapy, six weeks apart, before undergoing his scheduled prostatectomy.
Today, he is back in his home office, feeling well, and looking forward to a trip to Philadelphia. He recently attended a high school reunion where he met a former classmate who had gone through a similar prostate cancer diagnosis. The conversation was a powerful reminder of his unique journey —one man had followed the standard path, while Frottom was helping forge a new one.
Being the first has given him more than just a novel treatment; it has given him peace of mind. He is proud to be a pioneer in a study that could change the future for countless men.
John’s story is a powerful testament to two critical things:
- The Lifesaving Importance of Screening: His rapidly rising PSA was the alarm bell that allowed for early, decisive action. It’s a reminder for all men to stay on top of their health and get regular check-ups.
- The Power of Medical Innovation: Clinical trials like PRELUDE are the engine of progress. They offer patients access to the next generation of care and give hope where there was once uncertainty.
“We are eager to see if this promising therapy improves patient outcomes in men with high-risk localized prostate cancer,” Dr. Yerram stated.
For John Frotton and the men who will follow him, this trial is more than just a study. It’s a prelude to a future with less fear and a greater chance for a long, healthy life.
Trial Seeking New Patients
The PRELUDE Trial is actively recruiting eligible patients with localized, high-risk prostate cancer (Gleason Score of 8 or more) who are planning to have a radical prostatectomy. For more information, visit clinicaltrials.gov.
The PRELUDE trial (also known as the AUA 2024 PRELUDE trial) is a Phase II study investigating the effectiveness of lutetium (¹⁷⁷Lu)-PSMA-617 (Pluvicto®) as a neoadjuvant (pre-surgery) treatment for high-risk, localized prostate cancer. Patients receive two cycles of ¹⁷⁷Lu-PSMA-617 before a radical prostatectomy, with the trial aiming to assess the treatment’s impact on prostate cancer downstaging, tumor load, the safety of the surgery, and long-term recurrence rates.
Read more in Urology Times and an interview with Dr. Yerram.
