Adding abiraterone to hormone therapy at the start of treatment for prostate cancer improves survival by 37 per cent, according to the results of one of the largest ever clinical trials for prostate cancer presented at the 2017 ASCO Annual Meeting in Chicago and published in the New England Journal of Medicine.
This part of the STAMPEDE trial recruited around 1,900 patients. Half the men were treated with hormone therapy while the other half received hormone therapy and abiraterone. In men who were given abiraterone there was a 70 per cent reduction in disease progression. 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.
Dr. Stegall’s Comments: While hormone therapy (blocking testosterone production and activity) will likely remain the first line therapy for prostate cancer, there are times when this does not work. In those patients, abiraterone (brand name Zytiga) seems to offer benefit. In the past, failed hormonal therapy has meant that there are few, if any, solutions to prostate cancer short of surgery and radiation. More options are always better. In addition to the above study, there have also been cases where those who failed hormone blocking therapy responded well to giving testosterone. This seems paradoxical, and we do not fully understand why this is the case, but I believe it is worth considering in cases which are refractory to conventional treatments.