In the randomized double-blind phase 3 LATITUDE trial, which included 1199 patients with newly diagnosed metastatic hormone-naïve prostate cancer (mHNPC), investigators led by Karim Fizazi, MD, PhD, head of the Department of Cancer Medicine at Gustave Roussy, University Paris-Sud in Villejuif, France, found patients who received abiraterone and prednisone in addition to ADT had a 38% decreased risk of death and 53% decreased risk of radiographic progression compared with those who received placebo and ADT.
The call by a leading cancer researcher follows a breakthrough in blood testing, which could enable doctors to predict which sufferers of advanced prostate cancer will respond to new targeted treatments.
The hormone testosterone fuels the growth of prostate cancer cells.
However, he said that more men of African Caribbean origin were needed to take part in clinical trials so that the tests could be developed further.
Currently, men with prostate cancer that has spread to surrounding tissue in the pelvic area are only given hormone therapy. The men had either locally advanced or metastatic cancer, and all were commencing long-term standard ADT for the first time.
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"These results show that abiraterone used at the start of treatment had clear benefits for patients, with those who received the drug alongside hormone therapy over a third more likely to survive than those who did not", said de Bono. The three-year survival rate was 83 percent for those given the combination, compared with 76 percent for those getting only standard care. The effects were consistent across the different subgroups of people enrolled in the trial.
"But abiraterone is much easier to tolerate, with many patients reporting no side effects at all", he added, while cautioning that the drug should be used with care in men who have an increased risk of heart problems such as those with diabetes. Two treatment-related deaths happened in the Zytiga group and one in the standard therapy cohort. In about 20,000 of these patients the cancer has already colonised other parts when it is identified.
Researchers believe giving patients two drug treatments at once cuts disease progression and offers some patients the chance of a cure. Grothey said patients and oncologists agreed in the planning of the studies that a shorter duration of therapy, "should not sacrifice more than 12% of the benefit of adjuvant therapy". Data from the study are also contributing to indirect comparison of outcomes with adding docetaxel, abiraterone, and other treatments using a "network meta-analysis" approach.
The results of the IDEA worldwide collaboration, which involved more than 12,800 patients, demonstrated that a 3-month course of adjuvant chemotherapy is almost as effective as the standard 6-month course for patients with stage IIIC, lymph-node positive, colon cancer who have undergone surgery.
This study was funded by grants from Cancer Research UK, Medical Research Council, and Janssen, with additional contributions to the STAMPEDE protocol from Astellas, Clovis Oncology, Janssen, Novartis, Pfizer, and Sanofi-Aventis.