What's new and encouraging in prostate cancer treatment and research? This panel of experts, Dr. Bruce Montgomery,Moderator, Dr. Emanuel Antonarakis, Dr. Tomasz Beer, and Mr. Tom Kirk who is President and CEO of Us Too International, explain advances in research and treatment in 2015.
Prostate cancer patients and cancer patients in general will find some hopeful news in this discussion.
Post Text Here
To put a smile on your face see Larry's latest cartoon. To learn more about clinical trials, take a look at our book.
(c) 2012 Tom Beer and Larry Axmaker
Dr. Tom Beer attended the 2015
ASCO (American Society of Clinical Oncology) Annual Meeting in Chicago. He
wrote a paper about some of the recent
discoveries and important advances in prostate cancer treatment. This is a
summary of that paper. You can find the original in the Oncology
Journal.
A trial called STAMPEDE (Systemic
Therapy in Advancing or Metastatic Prostate Cancer: Evaluation of Drug
Efficacy) recruited men starting hormone therapy for high-risk, locally
advanced prostate cancer. Multiple arms of the study are testing the
addition of various agents to standard hormonal therapy. The results of adding
docetaxel, zoledronic acid, or both were reported at ASCO. Nearly 3,000 men have
participated in the study. The use of docetaxel, with or without zoledronic
acid, significantly increased overall survival. The bottom line‑the use of
chemotherapy with hormonal therapy in patients with advanced metastatic
prostate cancer was supported.
In Radiation Therapy Oncology Group study 0521, the
early use of chemotherapy was also evaluated, along with radiation and hormonal
therapy, in high-risk localized disease.[2] Six hundred twelve patients with
localized prostate cancer and features consistent with a high risk of relapse
were treated with radiation therapy and 2 years of hormonal therapy with or
without 6 cycles of docetaxel. The addition of chemotherapy resulted in an
improvement in the 4-year overall survival rate and improvement in 5-year
disease free survival. These results support earlier trials which found that
using chemotherapy in the initial management of metastatic prostate cancer
increased survival time. Additional follow-up is necessary before this becomes
standard treatment.
A French study, the GETUG-AFU 16
trial, used radiation in men with a PSA rise after a prostatectomy. A six month
regimen of hormonal therapy was added for some of the patients.
Progression-free survival was significantly improved in those patients
receiving the combination therapy.
How soon to begin hormonal
therapy in men with rising PSA levels was the focus of another study. Men were
randomly assigned to a group that started hormonal therapy in two years or four
years. The overall survival rate was significantly higher in the men who began
therapy at two years. A concern in using hormonal therapy is toxic side
effects. Early study results suggest earlier use of hormonal therapy may save
lives in spite of side effects. Larger, more definitive studies are needed to
test these results.
A comparison of the use of
intermittent hormonal therapy versus continual hormone therapy was the focus of
a study conducted by the Southwest Oncology Group (SWOG). One group of older
men received continual ongoing hormonal therapy and the other group intermittent
treatment. Early results suggest the intermittent treatment group had more
medical events over the time of the study than those on continual hormonal
therapy.
Hormonal therapy is routinely combined with
radiation for the treatment of high-risk and most intermediate-risk patients.
But in intermediate-risk patients, the combination is not as well studied and
questions about the need for hormonal therapy have been raised. A randomized
trial that involved 600 participants showed that biochemical and disease-free
survival with 6 months of hormonal therapy plus radiation were superior even to
results with dose-escalated radiation, providing support for the widely
practiced approach of combining these two treatment modalities.
Post Text Here
To put a smile on your face see Larry's latest cartoon. To learn more about clinical trials, take a look at our book.
(c) 2012 Tom Beer and Larry Axmaker
