New strategy prolongs survival in newly diagnosed men, the prostate cancer metastatic -
Men with metastatic newly diagnosed patients with hormone-sensitive prostate lived more a year when they received chemotherapy as initial drug treatment instead of waiting for the disease to become resistant to hormone blockers, report scientists at the Dana-Farber cancer Institute and the oncology Group Eastern Co-operative.
dramatic results in a multi center Phase III should change how doctors regularly treated these patients since the 1950s, they said.
"This is the first study to identify a strategy that prolongs survival in newly diagnosed cancer metastatic prostate," said Christopher J. Sweeney, MBBS, of Dana-Farber Lank Center for Genitourinary of Oncology. He presented the test results Sunday, June 1, 2014, at the annual meeting of the American Society of Clinical Oncology (ASCO) in Chicago.
"The advantage is considerable and warrants making a new standard treatment for men with high measuring disease and are fit for chemotherapy," said Sweeney, principal investigator for the study of national E3805 cancer Institute funded.
"the prolongation of survival observed in patients with prostate cancer participating in the Dr. Sweeney study is very impressive, considerably longer than the typical 2-6 month extension generally observed in studies successful other adults metastatic solid tumors, "said Bruce E. Johnson, MD, director of clinical research of Dana-Farber.
In current practice, newly diagnosed men with prostate cancer that has widely spread, which depends on male hormones to develop cancer, are started on medicines blocking hormone - therapy androgen deprivation therapy (ADT). Most tumors eventually outgrow their need hormones and cancer progresses. Then only patients begin chemotherapy.
The new trial tested the hypothesis that Sweeney hit immediately with cancer chemotherapy in addition to hormonal treatment would undermine the ability of tumor cells to repair the damage, delaying the development of resistance.
The study included 70 men with newly diagnosed metastatic disease; they were randomized to ADT ADT alone or with docetaxel (brand name Taxotere) over 18 weeks. In the ADT-only group, 124 patients received docetaxel when their cancer worsened. In the ADT-plus-docetaxel group, 45 patients whose disease progresses received additional docetaxel.
During a median follow-up of 29 months, 136 patients in the ADT-only group were dead against 101 in the group that received both drugs. This results in a median overall survival of 57.6 months for men who received early chemotherapy versus 44 months in the group receiving ADT as the sole initial treatment -. More than one additional year of life
In the 520 patients who had high extent of disease (including cancer had spread to major organs and / or bones), treatment with ADT plus docetaxel had a further advantage greater: these men had a median overall survival of 49.2 months against 32.2 in the ADT only group - a difference of 17 months.
previous test results were made public by the NCI in December 2013 due to strong positive results. Sweeney's presentation at ASCO covers updated and more detailed results.
The most striking advantages of survival with early use of docetaxel was found in men with a high burden of metastatic disease. Sweeney said more time is needed to assess the benefit of the drug combination in men with lower burdens of disease because their median survival has not been reached
The most adverse effects serious were neutropenic fever and neuropathy. one patient died as a result of treatment.
The addition of not only lengthened survival Docetaxel, but the progression of the disease delayed as measured by a specific increase of PSA (PSA), the appearance of new metastases or aggravation. Men receiving docetaxel had a median of 32.7 months before the cancer advanced by the worsening of test results or symptoms, compared with 19.8 months for hormone therapy alone.
"This study shows that early chemotherapy increases the chances that some patients with metastatic prostate cancer have a longer time without symptoms of cancer and also live longer," said Sweeney.
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