Professor Lloyd Trotman in his lab in 2018 at the Cold...

Professor Lloyd Trotman in his lab in 2018 at the Cold Spring Harbor Laboratory . Credit: Joseph D. Sullivan

New research from Cold Spring Harbor Labs shows that a compound related to vitamin K slowed the progression of prostate cancer in lab mice, offering a path for further study into one of the most commonly diagnosed cancers in men.

In the study, released in the new issue of the journal Science this week, scientist Lloyd Trotman and his colleagues explain how mice were given doses of menadione, the active component of vitamin K. They found the compound, also known as vitamin K3, triggered some of the cancer cells to burst and die.

Trotman, whose lab conducted the study, said he is hopeful men in the early stages of prostate cancer will see the same results. But first, scientists have to determine, among other things, how best to deliver the compound into humans.

He said some patients in the early stages of the disease don't need treatment but are monitored to make sure the cancer does not progress.

"Either they have blood work done periodically or they have a biopsy every half a year or so to see if the cells have become more aggressive," said Trotman, who is also a professor at Cold Spring Harbor Labs. "I think that would be the ideal target group."

There are no "clear directives" for some men at that stage even though it's a large proportion of patients, he said.

Dr. Manish Vira, system chief of urology at the Northwell Health Cancer Institute, agreed that the first group of men who should be studied as to the impact of menadione should be patients with early prostate cancer.

"If you give them this medication and you can slow the progression or slow the growth of the cancer, then perhaps we can prolong it such that they never need treatment," Vira said. "In prostate cancer, the trick is things don't happen right away ... In most patients who have prostate cancer, if we treat something today, we're trying to prevent an outcome that might be 5, 10, 15 or maybe even 20 years down the road."

Prostate cancer is the second most common cancer for men in the U.S., topped only by non-melanoma skin cancer, according to the Centers for Disease Control and Prevention.

The agency said 236,659 cases of prostate cancer were reported in 2021 and 33,363 men died from the disease in 2022.

But screening succeeded in catching 70% of the prostate cancers at the local stage between 2017 and 2021, according to CDC data. That means the cancer was contained in the prostate and did not spread throughout the body.

Trotman said there are many steps before the menadione compound is used in a human trial, such as continued work on the molecule and finding the most effective method of distributing it to patients.

Menadione is different from over-the-counter vitamin K. It is commonly used as a supplement in feed for horses.

"This isn't like a medicine that you can get at a pharmacy for a trial," Trotman said. "We'll have to do some work to be able to have it produced and give it to the men."

Because prostate cancer often has no symptoms early on, screening is important for men. They can take a blood test, where a sample is screened for prostate-specific antigen (PSA).

"In the past, less than four was normal and above four was abnormal," Vira said. "But we no longer use those reference ranges any more. What’s important is the trend over time."

Age is a key factor, he said. A 70-year-old man may have a PSA of 3 and its normal while a younger man might have 2.5 or 3 and its borderline abnormal.

Previous national studies had focused on the impact of vitamin E, an antioxidant, on reducing the risk of developing prostate cancer. Instead, in a trial that followed 35,533 men for more than 10 years, researchers found it may have increased the risk for some men. 

Trotman said he did the study to see how a prooxidant, like vitamin K3, would respond to the cancer cells and whether it could help prevent the disease. In general, antioxidants protect cells while prooxidants can cause damage.

"As we learn more about the mechanisms, we learn more about how it is similar in human prostate cancer, we might use this type of medication as a part of other treatments in various forms of prostate cancer," said Vira.

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