Combining a chemotherapy drug with first-line hormone therapy could help men diagnosed with prostate cancer live longer, a new clinical trial finds.
A team including researchers from The Institute of Cancer Research and The Royal Marsden found that the chemotherapy drug docetaxel prolonged survival for men starting standard hormone therapy.
Men on the combination lived an average of 10 extra months, compared with hormone therapy on its own.
The trial, of almost 3,000 prostate cancer patients treated with hormone therapy, also found that the combination reduced the number of painful incidents resulting from cancer that had spread to the bone.
The new research, published in The Lancet, was led by the Medical Research Council Clinical Trials Unit and funded by Cancer Research UK, Novartis, Sanofi-Aventis, Pfizer, Janssen, and Astellas, with support from the NIHR Biomedical Research Centre at The Royal Marsden and the ICR.
Long-term hormone therapy has been the standard treatment for advanced prostate cancer since the 1940s and in recent years newer drugs have proven effective at treating the disease when hormone therapy stops working.
The STAMPEDE clinical trial has a novel, multi-arm, multi-stage design testing several new approaches to treat prostate cancer. This part of the study was designed to test whether giving docetaxel to men with prostate cancer alongside hormone therapy could improve outcomes in those recently diagnosed with the disease.
Researchers found that men treated with hormone therapy alone survived an average of 71 months, but those who also received docetaxel lived on average 10 months longer.
Patients receiving both treatments also reported fewer skeletal-related events, which can reduce their quality of life and increase their risk of death, compared with hormone therapy alone.
Some 28% of men treated with hormone therapy reported pain from their prostate cancer spreading to their skeleton, compared with 19% of patients treated with combination hormone therapy and docetaxel.
As a result of the study recently updated NHS guidance recommends widening access to docetaxel for patients who have recently been diagnosed with advanced prostate cancer.
Professor David Dearnaley, Professor of Uro-Oncology at the ICR and a consultant at The Royal Marsden, said: “This study provides compelling evidence that front-line docetaxel treatment with hormone therapy substantially improves survival in men with advanced prostate cancer. We found that newly diagnosed prostate cancer patients who were treated with docetaxel and hormone therapy survived 10 months longer on average than men who received hormone therapy alone, with fewer incidents of bone pain, which is a common occurrence in prostate cancer.
“The findings show the drug could benefit more men with advanced prostate cancer and I’m pleased that NHS England has reacted very rapidly to recommend that docetaxel should be available to patients earlier in their treatment. Instead of receiving the drug after hormone therapy fails, docetaxel combined with hormone therapy should be the new standard of care for these men.”