Friday, 23 June, 2017

Quickly reporting cancer complications may boost survival

Prostate cancer trial stuns researchers: 'It's a once in a career feeling' 'Enormously exciting' prostate cancer treatment promises hope for more than 20000 men
Carol Daniels | 05 June, 2017, 08:40

The drug is usually given to men with advanced prostate cancer that has spread and has stopped responding to standard to hormone therapy, but this study shows the added benefit to patients who are about to start long-term hormone therapy. Three months of treatment yielded a slightly higher 3-year DFS with CAPOX (75.9% vs. 74.8%; HR = 0.95; 95% CI, 0.85-1.06) and slightly lower 3-year DFS with FOLFOX (73.6% vs. 76%; HR = 1.16; 95% CI, 1.06-1.26). Median OS for patients in the self-reporting arm was 31.2 months versus 26.0 months in the standard care cohort, which, he said, equated to an nearly 20 percent increase in survival time for these patients.

Basch's team is slated to present the findings on Sunday in Chicago at ASCO's annual meeting. It is the third most common cause of death from cancer, killing almost 27,000 Americans annually.

About 3 percent of US men newly diagnosed with prostate cancer have metastatic cancer, or cancer that has spread beyond the original tumor, said Dr. Karim Fizazi, head of cancer medicine at Gustave Roussy, University Paris-Sud in Villejiuf, France.

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.

Prostate cancer cells typically depend on testosterone to grow.

Chemotherapy drugs are administered to a patient at the North Carolina Cancer Hospital in Chapel Hill, N.C., on Thursday, May 25, 2017.

The phase III LATITUDE trial included men with prostate cancer that had already spread at the time of diagnosis, but who had yet to receive hormone treatment.

· or three or more visceral metastases.

Doctors say patients should speak up about side effects and not assume they're unavoidable.

At 30 months' follow-up, men treated with abiraterone had a 38 percent lower risk of death than those who got a placebo, and had a 53 percent lower risk of their cancer getting worse, the researchers found.

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Adding the abiraterone/prednisone combination to regular androgen deprivation therapy "should now be considered the new standard of care for these men", said Fizazi, who served as lead researcher for the clinical trial.

Sir Harpal Kumar, Cancer Research UK's chief executive, said: "These results could transform the treatment of prostate cancer".

A second study conducted by the University of Birmingham in the United Kingdom found that adding Zytiga to a standard initial regimen of hormone therapy for high-risk, advanced prostate cancer lowered the relative risk of death by 37 percent.

Around half of the men diagnosed are eligible for hormone therapy, which blocks the action of male sex hormones.

"We think this is one of the biggest survival gains ever reported in a trial in adults with solid tumor", he said. One obvious benefit is that the system enables better management of chemotherapy adverse effects, which allows patients to stay on their treatment longer.

The IDEA (International Duration Evaluation of Adjuvant chemotherapy) collaboration, involving more than 12,000 patients in six parallel clinical trials, was meant to see if shorter - and therefore less toxic - courses of post-surgical oxaliplatin-based chemotherapy are as effective as the current standard, according to Axel Grothey, MD, of the Mayo Clinic in Rochester, Minn.

Nerve damage - a key side effect of oxaliplatin - occurred less frequently in patients receiving a 3-month course of chemotherapy with both FOLFOX (15% vs. 45%) and CAPOX (17% vs. 48%).

"We need to be cautious when using abiraterone in men who have an increased risk for heart problems, such as those with diabetes", said Fizazi.

Abiraterone costs about $5,000 a month, according to The New York Times.

For more on hormone therapy for prostate cancer, visit the U.S.

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