For the third time in four years, researchers have found a new treatment option to combine with hormone therapy and improve life expectancy for men with advanced prostate cancer. The benefit is similar to the current standard treatment of docetaxel, but could provide an alternative for men who can't have chemotherapy.
New research released today shows that the drug enzalutamide can extend survival for men newly diagnosed with advanced prostate cancer compared to taking hormone therapy alone.
Currently in the UK, men diagnosed with advanced prostate cancer are given hormone therapy together with docetaxel chemotherapy. A second therapy, abiraterone, also similarly benefits these men, however it is still being appraised for this use on the NHS.
Today’s results show that enzalutamide, which is already licenced and available on the NHS for men who are resistant to hormone therapy, could be another treatment option for this group of men.
In the study, 1,125 men with hormone-sensitive metastatic prostate cancer were randomly assigned to receive either enzalutamide or another anti-androgen treatment alongside the standard of care (hormone therapy with or without docetaxel). It revealed that men on the enzalutamide arm of the trial were more likely to be alive after three years than men who had taken other anti-androgen treatments.
The results were announced at the American Society of Cancer Oncology conference in Chicago.
Dr Matthew Hobbs, Deputy Director of Research at Prostate Cancer UK said: “This is a positive trial that demonstrates the benefit of giving enzalutamide upfront to men diagnosed with advanced prostate cancer rather than waiting until their cancer stops responding to hormone therapy. However, it does not show that this is any more effective than the UK’s current standard practice of giving docetaxel chemotherapy upfront in combination with hormone injections. We therefore expect that to remain standard UK practice.”
For many decades, there had been no improvements on hormone therapy for treating men newly diagnosed with advanced prostate cancer. Enzalutamide is now the third treatment in four years shown to have a substantial impact on the life expectancy of men when used alongside hormone treatment. It follows similar findings for abiraterone, and the current standard of care, docetaxel.
Although the study showed no additional benefit of using enzalutamide over docetaxel, additional treatment options like these are still important.
“There are some men diagnosed with advanced prostate cancer who cannot have chemotherapies like docetaxel, and we want to see another treatment option made available to them so that they can benefit from the additional months of life that having abiraterone or enzalutamide can provide. We will be working with appraisal bodies and the manufacturers to find a way to make this happen,” explains Dr Hobbs.
We are currently funding Dr Jayne Tierney to compile the results of this study with other similar trials. This will give the researchers a large dataset, which they can use to predict the results of clinical trials that have not yet been published. She aims to be able to fast-track policy decisions on whether treatments like enzalutamide should be made widely available to men. This could also lead to more personalised treatment decisions in the future, so each man gets the most effective choice for him.
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