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New combination of old drugs improves survival of prostate cancer

20 September 2021

Giving the drug abiraterone alongside standard hormone therapy helps men with high-risk prostate cancer that has not spread elsewhere in the body to live longer, according to preliminary results of a 果冻影院-led trial.

果冻影院 researchers have invented a new test to identify the earliest genetic changes of prostate cancer in blood

This result from the STAMPEDE trial, based at the MRC Clinical Trials Unit at 果冻影院 and funded by Cancer Research UK and MRC, was presented today at the European Society for Medical Oncology (ESMO) Congress.听

Lead researcher Professor Gert Attard (果冻影院 Cancer Institute) presented an analysis of the impact of abiraterone, when used either听with or听without another drug, enzalutamide, when added to standard hormone therapy for men with prostate cancer where conventional imaging shows it has not spread elsewhere in the body.听听

988 men were randomised to receive standard of care (hormone therapy with or without radiotherapy). They were compared to 986 men who were randomised to receive abiraterone, plus standard of care (hormone therapy with or without radiotherapy). Of those in the abiraterone group, 527 men also received enzalutamide.听听

Abiraterone (Zytiga) is a type of hormone therapy that works in a different way to standard hormone therapy. Abiraterone is currently licensed to treat prostate cancer that鈥檚 spread to other parts of the body or has stopped responding to standard hormone therapy.听听

The proportion of men whose cancer hadn鈥檛 spread after six years in the 鈥榓biraterone-based therapy group; was 82%, compared with 69% in the 鈥榮tandard of care鈥 group.听听

The proportion of men alive after six years in the 鈥榓biraterone with or without enzalutamide鈥 group was 86%, compared with 77% in the 鈥榮tandard of care鈥 group.听听

Professor Attard said: 鈥淭he results are excellent news for us and our patients. Two years of abiraterone compared with standard treatment at diagnosis cures a significant proportion of men and delays the time to spread of the cancer. This translates into a very significant improvement in life expectancy for men with high-risk prostate cancer that鈥檚 not spread beyond the prostate听on conventional imaging.鈥澨

Dr Claire Amos (MRC Clinical Trials Unit at 果冻影院), operational lead for the trial, said 鈥淭his is a great result and one that would not be possible without the enormous efforts of the hospital staff who recruit and treat patients in the trial. Most importantly, we must thank the patients for agreeing to take part, none of this would be possible without them and these findings will be of great benefit to others in the future.鈥澨

Professor Mahesh Parmar, director of the MRC Clinical Trials Unit at 果冻影院, said: 鈥淭he STAMPEDE trial is the largest of its kind in high-risk prostate cancer and this has allowed us to combine data from a number of the research arms to get a robust and reliable result for this group of patients whose cancer has not spread. The results are very clear and impressive, and it is fantastic that using abiraterone improves the length of time before the disease spreads and improves the number of men surviving this disease.鈥澨

Professor Nick James, professor of prostate and bladder cancer research at the Institute of Cancer Research London听and consultant clinical oncologist at The Royal Marsden NHS Foundation Trust, is chief investigator of the STAMPEDE trial. He said: 鈥淪TAMPEDE is a practice changing trial that continues to make great strides in changing prostate cancer research and treatment. The depth and breadth of the trial has allowed us to examine aspects of care not studied in more focused trials.听听

Today鈥檚 results are the first study of intensified hormone therapy in this group. The results show that all men with high-risk prostate cancer that鈥檚 not spread to other parts of the body benefit substantially from听two years of听abiraterone treatment. Our findings will change the current standard of care worldwide. We are in active discussions with NHS England about how these findings can be implemented.鈥澨

A research paper with more details has been submitted to a journal and is undergoing peer review.听听

The STAMPEDE trial is funded by Cancer Research UK, the Medical Research Council, Astellas, Clovis Oncology, Janssen, Novartis, Pfizer and Sanofi-Aventis.

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    • Prostatic adenocarcinoma with perineural invasion. Credit:听听辞苍听听(CC BY-SA 3.0)

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