Combination therapy offers new hope for patients whose prostate cancer returns after surgery or radiation therapy and for whom other treatments no longer work.
MADRID, 26 Oct. (EUROPA PRESS).- Los men whose prostate cancer returning after surgery or radiation therapy may now benefit from a new combination of medications that, according to clinical trials of Cedars-Sinai Cancer, United States (EU)reduces the risk of death by more than 40 percent.
Combination therapy, which adds a drug called enzalutamide to the hormonal therapy commonly prescribed, reduced the mortality in patients with prostate cancer recurrent after surgery or radiotherapy, for whom other treatments are no longer an option. The results of the rehearsal are published in The New England Journal of Medicine (NEJM) and are presented simultaneously during the Congress of the European Society for Medical Oncology (ESMO) in Berlin, Germany.
“After initial treatment, some patients experience an aggressive recurrence of prostate cancer and are at risk for the disease to spread rapidly,” said Dr. Stephen Freedland, director of the Center for Integrated Cancer and Lifestyle Research at Cedars-Sinai Cancer and co-principal investigator of the study.
“Hormonal therapy, which we have been offering to our patients for 30 years, has not improved survival nor has any other therapy. Therefore, these findings represent a truly radical change,” he points out.
Clinical trial details
The trial included more than a thousand patients from 244 centers in 17 countries. All patients were diagnosed with what is known as high-risk biochemically recurrent prostate cancer. After surgery or radiotherapy, blood levels of prostate-specific antigen (PSA) increased rapidly. PSA is a protein used to detect prostate cancer, and a rapid rise in PSA levels after treatment indicates the likelihood of the cancer coming back and spreading, often to the bones or spine.
“We know that these patients are at high risk of developing metastatic disease and dying from cancer unless we offer them a meaningful treatment option,” says Freedland, professor of urology and holder of the Warschaw Robertson Family Law Chair in Prostate Cancer.
Patients were randomly selected to receive standard hormone therapy alone, enzalutamide alone, or a combination of both. After eight years, the risk of death was 40.3 percent lower in the combination group than in the other two groups, Freedland adds.
“This clinical trial, one of many that Cedars-Sinai Cancer has offered to its patients, is an example of the transnational work our physician-scientists do,” adds Dr. Robert Figlin, interim director of Cedars-Sinai Cancer. “The result will be better treatment and better outcomes for patients around the world.”
Outlook and consolidation of standard treatment
Freedland notes that, based on previous results published by the team, enzalutamide is approved by the Food and Drug Administration (FDA), and is listed in the National Comprehensive Cancer Network (NCRN) treatment guidelines. He added that these latest results will likely strengthen the network’s recommendation and solidify this drug combination as the standard treatment for patients with high-risk biochemically recurrent prostate cancer.
“These important findings identify a treatment that prolongs survival in men with aggressive prostate cancer,” said Dr. Hyung Kim, urologic oncologist and director of the Department of Urology at Cedars-Sinai. “The latest analysis complements previous studies that showed that enzalutamide significantly improved survival in other prostate cancer cases and will change the way we care for our patients.”
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