Earlier chemotherapy extends lives of men with advanced prostate cancer
"All men who are well enough and who have prostate cancer which has spread, should be offered this combination of treatments” - Professor Peter Johnson, Cancer Research UK
The drug, called docetaxel, is typically only offered if standard hormone treatment has failed. But these findings, that will be presented at the American Society of Clinical Oncology (ASCO) conference, show treating patients whose cancer has already spread earlier extended survival by almost two years.
Experts say the results provide sufficient evidence to suggest that the treatment should be offered to newly diagnosed men whose disease has already spread.
In the study of 2,962 men, those who received docetaxel plus standard hormone therapy at the start of their treatment lived an average of 10 months longer than those who received only hormone treatment.
For patients whose cancer had already spread beyond the pelvis, the average increase in life expectancy was 22 months.
The results form part of the STAMPEDE trial (Systemic Therapy in Advancing or Metastatic Prostate Cancer: Evaluation of Drug Efficacy), the largest trial of its kind for men with prostate cancer.
The study was part-funded by Cancer Research UK, and the charity’s chief clinician, Professor Peter Johnson, said the findings suggest that the combination treatment should be offered to men whose prostate cancer has spread.
“The chemotherapy is already used to treat lots of different cancers, including late-stage prostate cancer, but this important study that Cancer Research UK helped fund shows that it should be given earlier in a man’s treatment,” he said.
“Chemotherapy isn’t suitable for everyone, but all men who are well enough and who have prostate cancer which has spread, should be offered this combination of treatments.”
Prostate cancer is among the most common cancers in men in the UK. Over 40,000 new cases are diagnosed every year in the UK, while almost 11,000 men die from the disease.
In this trial, being run across Britain and Switzerland, patients were randomly assigned to different treatment groups. Some were given doses of docetaxel alongside standard therapy at the start of their treatment, while others received only standard treatment.
Patients who received the combination saw overall survival increase from 67 months to 77 months - while for those whose cancer had already spread, survival increased from 45 months to 65 months.
The combination treatment also extended the time before the patients’ disease came back by over a third (28 per cent) across all men on the study.
“We hope our findings will encourage doctors to offer docetaxel to men newly diagnosed with metastatic prostate cancer, if they are healthy enough for chemotherapy,” commented lead author Nicholas James, director of the Cancer Research Unit at the University of Warwick.
Given the reduction in risk of relapse the researchers also suggest that the combination could be offered to men who have advanced disease, but whose prostate cancer has not spread.
But they caution that a longer period of follow-up will be needed to assess whether there is any survival advantage for men treated at that stage.
This study received funding and support from Cancer Research UK, the Medical Research Council, the UK National Cancer Research Institute, the UK Department of Health, Sanofi-Aventis, Novartis, Pfizer, Janssen, and Astellas.