Double dose of prostate drugs boosts survival rate by 40%

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In men who were given abiraterone there was a 70 per cent reduction in disease progression.

Combined therapy with abiraterone acetate/prednisone plus androgen deprivation therapy (ADT) significantly improved overall survival and radiographic progression-free survival (PFS) among men with metastatic hormone-naive prostate cancer compared with ADT and placebo alone, according to the results of the phase III LATITUDE trial (abstract LBA3) presented at the 2017 ASCO Annual Meeting.

The trial, called STAMPEDE, involved almost 2,000 men with advanced prostate cancer who were starting hormone therapy, said lead researcher Nicholas James, a professor of clinical oncology at Queen Elizabeth Hospital in Birmingham, England. "This is one the biggest reductions in death I've seen in any clinical trial for adult cancers".

Prof Johann de Bono said they showed that when used at the start of treatment, abiraterone had "clear benefits for patients".

"The improvement in survival we saw may seem modest, but it is greater than the effect of many targeted cancer drugs for metastatic cancer", Basch noted in an ASCO news release.

The results of these trials are "pretty likely to change clinical practice overnight", said ASCO Chief Medical Officer Dr. Richard Schilsky.

During trials, researchers were able to detect tumour DNA in men's blood and pick out cancers with multiple copies of the androgen receptor gene, which many prostate cancers rely on to grow. The doctors explained that surgery wasn't an option for me because the cancer had spread beyond my prostate.

Tesaro said early-stage trial data suggested its Zejula (niraparib) could be used in combination with anti-PD1 immunotherapies such as Keytruda, or Bristol-Myers Squibb's rival, Opdivo (nivolumab).

The medicine is part of a new class of cancer treatments called PARP inhibitors which work by trying to stop cancer cells from repairing themselves. "I'm still on the trial, which I find reassuring and, fortunately, my cancer is being managed well".

See also: The immuno-oncology market prepares for the inevitable question: 'What's next?' LATITUDE: A phase III, double-blind, randomized trial of androgen deprivation therapy with abiraterone acetate plus prednisone or placebos in newly diagnosed high-risk metastatic hormone-naïve prostate cancer.

"But with one in four black men likely to get prostate cancer in their lifetime, we would hope this new test helps those with more advanced disease to receive more targeted treatment, which should mean better outcomes and quality of life".

Men whose prostate cancer has spread can now expect to survive around 3.5 years, however under the new strategy this is expected to become seven.

In the subset of patients with lower-risk colon cancer (60% of study participants) - defined as cancer spread to one to three lymph nodes and not completely through the bowel wall - DFS at 3 years appeared nearly identical for those who received 3 months and 6 months of treatment (83.1% vs. 83.3%; HR = 1.01; 95% CI, 0.9-1.12).

Both clinical trials received support from abiraterone's manufacturer, Janssen Biotech. "This study adds to the importance of the drug". The research was conducted as part of the Stampede trial, an ongoing randomized trial conducted in the United Kingdom and Switzerland. More data will come out in subsequent years, because of the innovative design of the trial.Professor James added: "We are so incredibly thankful to the patients and clinical staff who have agreed to take part in this study". He added that with their generosity, scientists could carry out research that will help save many lives.

Shi Q, et al.

Right now, Zytiga is approved only for patients with castration-resistant prostate cancer.

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