Researchers believe that starting chemotherapy drug docetaxel at the same time as hormone therapy can improve survival for men with advanced prostate cancer.

This British-led clinical trial sought to test whether adding chemotherapy up front would help prolong the lives of men with prostate cancer. The study was named Systemic Therapy in Advancing of Metastatic Prostate Cancer: Evaluation of Drug Efficacy.

Researchers recruited nearly 3,000 prostate cancer patients since 2005 who had never had hormone therapy together. About three in five mean in the study had prostate cancer that had spread to other parts of their bodies, while the rest had high-risk, advanced prostate cancer that had not yet spread.

The patients then entered one of four treatment regimens. All the patients were given three years of hormone therapy. One group only received the hormone therapy; another group was given the chemotherapy drug docetaxel in addition to the hormone therapy. The third group got zoledronic acid, a drug used to treat prostate cancer that has spread to bones, along with hormone therapy. The final group received hormone therapy, docetaxel and zoledronic acid.

Chemotherapy is generally given after hormone therapy stops working. However, the new study found that when the two therapies are paired at the start of treatment, patients lived an average of 10 months longer.

The study has found that the combination had even greater benefits for men whose prostate cancer has spread to other parts of their bodies, referred to as metastatic cancer. Men with metastatic cancer experienced an average of 22 month improvement in their overall survival

Researchers hope that these findings will encourage doctors to offer docetaxel to men newly diagnosed with metastatic prostate cancer, if they are healthy enough for chemotherapy.

Hormone therapy has been the standard treatment for men with advanced prostate cancer. Men are usually treated by shutting off the production of male hormones, either surgically or with drugs.

This tactic has been followed because hormone therapy is less toxic and has fewer side effects than chemotherapy. Unfortunately cancer doctors only resort to chemotherapy once there is no more response to the hormone therapy. This strategy allows the disease to evolve to a point where it is much more aggressive.

The findings from the study are scheduled to be presented May 31st at the annual meeting of the American Society of Clinical Oncology in Chicago. Research presented at meetings is generally viewed as preliminary until published in a peer-reviewed journal.

Gerry Oginski
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