Initial chemotherapy plus hormone Rx extends life in men with advanced prostate cancer

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Prostate cancer is the most common type of cancer in men. In 2015, there are expected to be 220,800 new cases of prostate cancer in the United States. Prostate cancer is the second leading cause of cancer death in American men (lung cancer is by far the leading cancer killer).

chemotherapyProstate cancer is the most common type of cancer in men. In 2015, there are expected to be 220,800 new cases of prostate cancer in the United States. Prostate cancer is the second leading cause of cancer death in American men (lung cancer is by far the leading cancer killer).

Currently, chemotherapy is generally offered for patients with prostate cancer only after standard hormone therapy (aimed at reducing androgen levels) stops working. But according to new research, men who start the chemotherapy drug docetaxel at the same time as standard hormone therapy live on average 10 months longer than men who received hormone therapy alone. The combination of the two treatments was even greater for men with metastatic cancer (cancer that spread to other parts of their bodies). For these men, the average improvement in overall survival averaged 22 months.

The research, led by Dr. Nicholas James, director of Cancer Research at the University of Warwick in Coventry, England, will be presented at the end of the month at a major conference hosted by The American Society of Clinical Oncology.

The study enrolled almost 3,000 prostate cancer patients since 2005. None of the men had ever had hormone therapy. They were assigned to four different treatment groups: only standard hormone therapy, docetaxel in addition to hormone therapy, zoledronic acid (a drug used to treat cancer that has spread to the bones) in addition to hormone therapy, and both docataxel and zoledronic acid in addition to hormone therapy.

After an average follow up of 42 months, 948 men had died. Overall survival in the docataxel and hormone therapy group was 77 months, compared to 67 months in the hormone therapy only group. For patients with metastatic cancer, overall survival was 65 months in the docataxel/hormone therapy group, compared to 43 months in the hormone therapy only group. Docetaxel also extended the time to relapse by 38 percent in all patients. The researchers also note that zoledronic acid was not found to have any impact on survival in either group that was given it.
Dr. James said of the results: 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. Men with non-metastatic advanced prostate cancer may also consider docetaxel as part of upfront therapy, as it clearly delays relapse.