Christopher J. Sweeney of Dana-Farber Cancer Institute's Lank Center for Genitourinary Oncology said currently, men newly diagnosed with prostate cancer which spread widely and whose cancer depends on male hormones to grow, were started on hormone-blocking medications -- androgen deprivation therapy. Most tumors eventually outgrow their need for hormones and the cancer progresses, and only then do patients begin chemotherapy, Sweeney explained.
The trial involved 790 men newly diagnosed with metastatic prostate cancer. Half were randomized to receive ADT alone or ADT with docetaxel --Taxotere -- over 18 weeks. In the ADT-only group, 124 men were given docetaxel when their cancer worsened. In the ADT-plus-docetaxel group, 45 patients whose disease progressed received additional docetaxel.
Sweeney hypothesized immediately hitting the cancer with chemotherapy in addition to hormone treatment would impair the tumor.
"This the first study to identify a strategy that prolongs survival in newly diagnosed, metastatic prostate cancer," Sweeney said in a statement.
"The benefit is substantial and warrants this being a new standard treatment for men who have high-extent disease and are fit for chemotherapy."
The study found, at a median followup of 29 months, men who received early chemotherapy had more than a year of additional life compared to the group who had the chemotherapy delayed.
However, the men whose cancer spread to major organs or bones treated with ADT plus docetaxel had an even greater benefit -- they had a median overall survival of 49.2 months, or 17 more months than those in the ADT-only group.
Sweeney presented the findings at the annual meeting of the American Society of Clinical Oncology in Chicago.
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