Posted on 12/28/2021 12:00:57 PM PST by Red Badger
Adding abiraterone to the standard treatment for locally advanced prostate cancer, where the cancer has a high chance of spreading, could halve the risk of death from the disease.
The researchers suggest that hormone therapy using abiraterone with prednisolone, could significantly reduce prostate cancer deaths and improve outcomes for thousands of people every year.
Using abiraterone for this group of people is now being considered for use in NHS England based on this research. If successful, it could be rolled out to patients immediately.
The study, published today in The Lancet, is part of the STAMPEDE trial and was led by a team at University College London and The Institute of Cancer Research, London and funded by Cancer Research UK and the MRC. The study followed patients over a six-year period.
Abiraterone for earlier-stage prostate cancer
More than 52,000 people are diagnosed with prostate cancer every year in the UK, and around 22,000 patients are considered at "high-risk" of their cancer spreading.
Abiraterone is currently being used for patients with advanced prostate cancer which has spread to other parts of the body. It's also given to men who have stopped responding to standard hormone treatment. The drug is given in combination with a steroid called prednisolone.
However, there have remained questions over its benefits and impact on survival in earlier-stage disease.
A total of 1974 patients were enrolled across two arms of the trial. 988 were given the current standard treatment, while 986 patients were given the standard treatment combined with abiraterone. Around half of those in the abiraterone group were also given enzalutamide, another hormone therapy.
'Could extend lives and prevent cancer from spreading'
After 6 years of monitoring, adding abiraterone alone, or with enzalutamide to standard prostate cancer treatment improved survival and decreased the chance of the cancer spreading. 7 percent of people receiving abiraterone died from prostate cancer during the 6-year follow up period, compared with 15 percent of those receiving standard care.
Around half of the people in the abiraterone group (527/986 men) also received enzalutamide, another type of hormone drug. However, using this combination of drugs did not further improve outcomes beyond those receiving abiraterone on its own, and caused an increase in side effects.
These results indicate that using abiraterone to treat earlier stage prostate cancer could extend lives and prevent the cancer from spreading.
The STAMPEDE trial is based at the MRC Clinical Trials Unit at UCL and led in collaboration with researchers at UCL Cancer Institute and The Institute of Cancer Research, London.
Researchers at The Institute of Cancer Research (ICR) with funding from Cancer Research UK discovered abiraterone and developed it with colleagues at The Royal Marsden. In 2012, Cancer Research UK lobbied to make abiraterone available on the NHS and its now used to treat thousands of patients with prostate cancer that has spread.
Preventing unnecessary deaths
Study co-leader Professor Nick James, Professor of Prostate and Bladder Cancer Research at The Institute of Cancer Research, London, and chief investigator of the STAMPEDE trial, said:
"STAMPEDE continues to deliver practice-changing results. Currently, abiraterone is only given to patients with very advanced prostate cancer. Our latest findings are the first to show the drug can also benefit men whose cancer is at an earlier stage—improving survival and reducing the chance of progression. The next step is for NICE to consider and implement our findings, so that men can benefit from abiraterone before their cancer has spread, drastically improving their quality of life and preventing many unnecessary deaths."
Study co-leader Professor Gert Attard, UCL Cancer Institute said:
"This is the first time we've seen a treatment for this kind of prostate cancer that can do more than extend life. We're seeing clear and convincing evidence that some people who would have died of prostate cancer, the third leading cause of cancer death in the UK, will no longer die from it."
Yet more people could soon benefit from this research
Michelle Mitchell, Chief Executive of Cancer Research UK, said:
"These results are the latest in a long line of practice changing findings from our STAMPEDE trial. It's recruited over 10,000 patients and has led to 29 changes in clinical practice across the world, directly influencing the treatment of people with prostate cancer. It's great to see that yet more people with prostate cancer could soon see benefit from this innovative research."
Ken was diagnosed with prostate cancer in 2015 and was offered the chance to be part of a separate part of the STAMPEDE trial, looking at a hormone treatment for prostate cancer called Zoladex. He said:
"My treatment would not have happened but for someone before me taking part in a clinical trial, so I just wanted to give something back. Knowing that people with prostate cancer might have better odds in the future in part because of what they learnt from my trial feels like I've paid it forward."
Five years down the line, Ken is enjoying life. He continues to be monitored and has been able to have phone consultations every three to six months throughout the COVID-19 pandemic.
Explore further
Prostate cancer treatment: An encouraging combination therapy
More information:
Gerhardt Attard et al, Abiraterone acetate and prednisolone with or without enzalutamide for high-risk non-metastatic prostate cancer: a meta-analysis of primary results from two randomised controlled phase 3 trials of the STAMPEDE platform protocol, The Lancet (2021).
DOI: 10.1016/S0140-6736(21)02437-5
Journal information: The Lancet
Provided by Institute of Cancer Research
Using abiraterone for this group of people is now being considered for use in NHS England based on this research. If successful, it could be rolled out to patients immediately.
A slow and cautious approach for a new and experimental protocol. It sounds like ... science.
It also doubles the life expectancy of men with advanced metastatic prostate cancer as well. Cuts off testosterone production from the pituitary gland.
Ping
Sounds like a far better option than was offered to my poor old dad.
I am sorry you dad had cancer. It sucks.
for thousands of people every year.
Curious phasing..can’t bring themselves to say “men”?
Well, at least they didn’t say “impregnating persons”..................
Yes it does. I’m happy to hear there are new treatments less barbaric than those my dad had to undergo years ago.
I’m an 18 year patient. I recently started enzalutimide plus Lupron and in 6 weeks knocked my PSA down 98%. Doctor wants me on the combination for a year. I’m stopping with 0.07 PSA and getting more information. There’s no sense in training resistant cells.
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This is good to know about; my BiL has had stage 4 prostate cancer for over a year now.
This may be news in Great Britain, but this has been known for years at MD Anderson.
Contrary to the article, while it may slow down the progress, it in no way means a man will not die of prostate cancer.
I was diagnosed with metastatic prostate cancer over seven years ago. Currently on Lupron and Enzalutimide for the past 3+ years. PSA is undetectable.
Every case is different, and not all therapies work for every man. With some men, nothing works for long.
Where is he being treated?
Roswell, NM. Not any great center of cancer excellence or anything.
Very encouraging…continued good fortunes.
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