Giving men with advanced prostate cancer a testosterone-blocking drug as a first line of defence could cut their risk of dying from the disease by more than a third and double the life expectancy of some.
Each year more than 46,000 men in the UK are found to have tumours in the gland beneath the bladder, and the disease kills 11,000 people. In about 20,000 of these patients the cancer has already colonised other parts when it is identified. At present the standard treatment is androgen deprivation therapy (ADT), which starves the tumour of testosterone and the other hormones it needs. When ADT stops working the patients are given abiraterone, which shuts down the production of male sex hormones.
A trial organised by Cancer Research UK has shown that giving men abiraterone at the same time as ADT cuts the odds of dying over three years by 37 per cent and the odds of a relapse by 71 per cent.
Among stage IV patients, whose cancers have spread widely by the time they are diagnosed, the combination therapy could raise average life expectancies from three and a half years to seven, researchers said. Nicholas James, professor of clinical oncology at the University of Birmingham and the trial’s lead scientist, said that the findings would transform the way the cancer was treated. “These are the most powerful results I’ve seen from a prostate cancer trial,” he said at the American Society of Clinical Oncology conference in Chicago.
The research involved 1,917 patients aged 67 on average. Between 2011 and 2014, half were given ADT and half received abiraterone and ADT. By the end of the study fewer than one in 20 of the abiraterone group had relapsed, compared with a quarter of the ADT-only group. The drug was discovered at the Institute of Cancer Research in London. Paul Workman, the institute’s chief executive, said that it should be assessed as a treatment of first resort for advanced prostate cancers.
