New ways of treating aggressive prostate cancer have shown “promise” in a major clinical trial.
The results of the international study, published in the New England Journal of Medicine, point to two potential treatment options that improve patients’ chances of survival.
More than 52,000 men are diagnosed with cancer of the prostate, a walnut-sized gland that helps make semen, in the UK every year on average – 144 men every day.
And more than 12,000 men die every year in the UK from the disease, one every 45 minutes.
One in eight men will be diagnosed with prostate cancer in their lifetime, according to official figures.
Now researchers at Cedars-Sinai Medical Centre in the US have offered them fresh hope after they identified two promising new treatment options for men with recurrent prostate cancer.
Both treatments helped patients live longer without their disease progressing than the current standard treatment.
Study lead author Dr. Stephen Freedland said: “If these treatments are approved by the Food and Drug Administration, our results will be practice-changing.
“In the study, both of these new options improved metastasis-free survival while preserving quality of life.”
He said treatment may never be needed for some prostate cancer patients because they have a slow-growing form of the disease.
However, those with more aggressive prostate cancer are often first treated with surgery or radiation therapy.
Dr. Freedland said. “Unfortunately, in about a third of those patients, the cancer recurs within 10 years.”
Patients with aggressive recurrence are treated with androgen deprivation therapy (ADT), also known as hormone therapy, which reduces their production of the sex hormone testosterone.
The hormone helps prostate cancer cells grow and spread, and ADT effectively reduces the growth-stimulating effects.
But Dr. Freedland says ADT has two downsides: It doesn’t completely eliminate testosterone, and it can cause several unpleasant side effects.
He said: “When you go on ADT, the testosterone level in the blood is reduced, but not completely eliminated.
“And the concern is that the testosterone that remains may still be enough to stimulate tumour growth.
“Also, patients don’t love the idea of being on hormones.”
In the new study of 1,068 prostate cancer patients from 244 sites in 17 countries, Dr. Freedland and fellow researchers tested two experimental interventions – one to address each of the issues.
A third of the patients received ADT plus a medication called enzalutamide, which blocks the effects of testosterone.
Dr. Freedland explained that enzalutamide keeps any testosterone remaining in the blood from stimulating the growth of cancer cells.
Another third of the patients received enzalutamide alone. That option relied on the medication to block the effects of testosterone, even though testosterone levels in the patient’s blood were not reduced.
Dr. Freedland said: “We wanted to see whether enzalutamide on its own was so effective that we didn’t need the ADT.”
The final group of patients received ADT alone, which is the current standard treatment.
The research team found that the combination of ADT plus enzalutamide reduced the risk of metastasis or death by 58 percent over ADT alone.
They found that enzalutamide alone reduced the risk of metastasis or death by 37 percent over ADT alone.
Both treatments maintained quality of life relative to the ADT alone.
Dr. Freedland said.: “While the combination therapy offers greater risk reduction, some men might prefer enzalutamide alone.
“It does a good job of preventing cancer spread or death, with different side effects that may be more acceptable for some men.”
He says the next step is for the makers of enzalutamide to apply for FDA approval, so the experimental therapy can come into wide use.
Dr. Dan Theodorescu, director of Cedars-Sinai Cancer, added: “Optimising therapy for patients with aggressive recurrence after their prostate cancer is initially treated has been an unmet need.
“The results of this trial point the way to two options which the study showed were more effective than current standard of care, giving these patients and their providers the opportunity to choose a potentially improved course of therapy that best meets their needs.”
Produced in association with SWNS Talker
