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New prostate cancer study paves way for potential treatment changes

minority menResults of a phase 3 clinical trial will change the way oncologists treat advanced prostate cancer. The findings were announced this weekend at the American Society of Clinical Oncology annual meeting, where oncologists throughout the country present information on new cancer research.

Maha Hussain, M.D., a medical oncologist who treats prostate cancer patients at the University of Michigan Comprehensive Cancer Center, is one of the co-authors on the study.

mCancerTalk: What is the key finding of this study?

Dr. Hussain: This study found that adding the chemotherapy drug docetaxel to standard hormone therapy extends survival by about 13.5 months for men with newly diagnosed hormone-sensitive metastatic prostate cancer. Currently, standard therapy is to treat men with androgen deprivation therapy and then to use docetaxel after the cancer progresses. This study indicates that men with what we call high-extent disease, meaning it has spread extensively, have an even greater response to the addition of docetaxel with androgen deprivation therapy – a 17-month improvement.

mCancerTalk: Why is this exciting?

Dr. Hussain: This study provides the longest ever prolongation of life in patients with metastatic hormone sensitive prostate cancer, since hormone therapy was established as the back bone treatment for this stage of disease 70 years ago.

mCancerTalk: Why has docetaxel traditionally been used only after ADT fails?

Dr. Hussain: That’s where docetaxel was first tested and demonstrated improvement in survival. This led to the U.S. Food and Drug Administration approving docetaxel for prostate cancer in 2004. It is interesting that the new data is at the 10th anniversary of the docetaxel FDA approval.

mCancerTalk: Is it surprising to you that the addition of docetaxel provided more benefit in men with more extensive disease spread?

It’s not entirely surprising, though it’s important to point out that the percentage of low volume patients is small. Coupled with the fact these patients tend to do relatively well anyway, it would have necessitated more low volume patients to be included and longer follow up time to better assess the potential benefit.

mCancerTalk: How quickly do you anticipate this therapy might be implemented in patients? Is more study needed?

Dr. Hussain: The robustness of the data and the fact that docetaxel has a track record in treating metastatic castration-resistant prostate cancer lead me to conclude that more similar studies are not necessarily warranted. There are other trials that have looked at earlier use of docetaxel in hormone-sensitive disease that will hopefully provide more information. Personally, I will offer this option for patients who have high volume/poor risk disease and who are docetaxel candidates, and I will also counsel patients with low volume disease on the study results. All patients should be appropriately informed of the results of this trial.

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Maha Hussain, M.D.Maha Hussain, M.D., FACP, FASCO, is the Cis Maisel Professor of Oncology and associate director for clinical research at the U-M Comprehensive Cancer Center. She is also the co-leader of the prostate cancer/genitourinary oncology program. Hussain is an internationally renowned clinical researcher and an expert in genitourinary malignancies, particularly prostate and bladder cancers. Her research efforts are focused on the development of novel therapeutics integrating scientific advances into clinical trials for prostate and bladder cancer. She has served as the co-chair for the Prostate Cancer sub-committee of SWOG GU committee, where she guided national research in areas of advanced prostate cancer that led to changing standards of care.

 
University of Michigan Comprehensive Cancer CenterThe University of Michigan Comprehensive Cancer Center’s 1,000 doctors, nurses, care givers and researchers are united by one thought: to deliver the highest quality, compassionate care while working to conquer cancer through innovation and collaboration. The center is among the top-ranked national cancer programs, and #1 in Michigan for cancer patient care. Seventeen multidisciplinary clinics offer one-stop access to teams of specialists for personalized treatment plans, part of the ideal patient care experience. Patients also benefit through access to promising new cancer therapies.