Health Care

Quickly reporting cancer complications may boost survival

Quickly reporting cancer complications may boost survival

The addition of abiraterone acetate to standard initial treatment reduced the risk for death among men with high-risk advanced prostate cancer by 37%, according to results of the STAMPEDE trial presented at the ASCO Annual Meeting.

Doctors now combine the chemotherapy drug docetaxel with hormone therapy to treat patients with advanced prostate cancer, where the cancer has spread to the bone or other parts of their body, the researchers said.

The STAMPEDE trial was funded by the Cancer Research UK, and researchers believe the drug could change the standard of care for men with prostate cancer. For now, this is not known, and the researchers are planning molecular analyses of tissue samples collected in the study to see if a subset of patients would benefit more from adding either docetaxel or abiraterone.

"Compared to standard care, patients who self-reported symptoms experienced multiple, statistically significant, clinical benefits", said Basch, MD, MSc, FASCO, professor of medicine at the Lineberger Comprehensive Cancer Center of the University of North Carolina, who was practicing at Memorial Sloan Kettering Cancer Center (MSK) when the study was conducted.

'This is one of the biggest reductions in death I've seen in any clinical trial for adult cancers.' Half of the 1,917 men in the trial received hormone therapy alone and the other half the combination.

"We have to realize that these drugs that we use to treat prostate cancer are double-edged swords", Brawley said.

"As part of the trial, I started taking abiraterone four times a day and had a hormone injection every eight weeks", he said.

One patient who participated in the trial, Alfred Samuels, 59, was diagnosed with advanced prostate cancer in January 2012.

He said: "It felt like my world fell apart overnight".

STAMPEDE is an ongoing multi-arm, multi-stage randomized clinical trial conducted in the United Kingdom and Switzerland.

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Professor Paul Workman, chief executive of the Institute of Cancer Research, London, said: "Abiraterone has already hugely improved the outlook for hundreds of thousands of men with advanced prostate cancer worldwide".

"You want to be able to reach your provider as early and easily as possible", because a sign like shortness of breath may mean treatment isn't working and needs to be changed, he said.

Patients initiating routine chemotherapy for metastatic solid tumors at Memorial Sloan Kettering Cancer Center in NY between September 2007 and January 2011 were invited to participate in the trial; participants were randomly assigned either to the usual care group or to the PRO group, in which patients provided self-report of 12 common symptoms at and between visits via a web-based PRO questionnaire platform.

According to the investigators, adverse events were consistent with experience for castration-resistant prostate cancer. Standard hormone therapy blocks the action of male sex hormones, halting the disease. "Abiraterone can clearly help many more prostate cancer patients than was first thought".

It also lowered the chance of the cancer getting worse by 71 per cent compared with men just on ADT.

More than 161,000 new cases of prostate cancer are expected to occur in US men in 2017, almost 10 percent of all new cancer cases, according to the National Cancer Institute.

Late previous year Pfizer and its partners at Astellas conceded that Xtandi combined with Zytiga and prednisone failed to bend the curve on progression-free survival for chemo-naïve patients whose disease had progressed following treatment with Xtandi, compared with a group of patients treated with Zytiga and prednisone alone. "This approach reduces emergency room visits by 7%, improves quality of life by 31%, lengthens time that patients tolerate chemotherapy by 2 months, and ultimately lengthens survival by a median of 5 months", he reported.

The Institute of Cancer Research also "strongly welcomed" the new findings.

Workman added that the drug is a highly innovative treatment that not only improves survival rates but has lower rates of side-effects, compared to conventional therapies.

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