SIGNIFICANT improvements to survival rates in prostate cancer patients have been found to result from the addition of abiraterone to hormone therapy at the beginning of treatment. These findings were from the STAMPEDE trial and are very promising. Indeed, the chief investigator, Prof Nicholas James, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK, stated: “These are the most powerful results I have seen from a prostate cancer trial: it is a once in a career feeling. This is one of the biggest reductions in death I have seen in any clinical trial for adult cancers.”
In this section of the trial, about 1,900 patients were recruited and randomised on a 1:1 basis to either hormone therapy or hormone therapy plus abiraterone. It was found that there was a 70% reduction in disease progression in patients who were given hormone therapy plus abiraterone. Overall, the survival rate was improved by 37%. Furthermore, the rate of severe bone complications, which are often a major issue in prostate cancer patients, was reduced by >50%.
Abiraterone improves upon hormone therapy, which blocks the action of male sex hormones to halt the spread of prostate cancer, by preventing the production of the hormones that facilitate the growth of prostate cancer. The drug is already used in the treatment of advanced prostate cancer that is no longer responsive to hormone therapy and has spread; however, these results suggest that abiraterone could be used alongside hormone therapy as a first-line treatment. Prof James noted: “Abiraterone is already used to treat some men whose disease has spread but our results show many more could benefit.”
This is the latest result to come out of the STAMPEDE trial; previous findings have led to changes in practice for men with prostate cancer, with docetaxel chemotherapy becoming part of the standard of care. The design of the trial is an innovative one that may be replicated in the future. Speaking about the impact of the trial design, Sir Harpal Kumar, Chief Executive, Cancer Research UK, London, UK, explained: “The STAMPEDE trial is changing the face of prostate cancer because the flexibility of the trial design means that we can investigate a number of different treatment options rapidly and in parallel, enabling scientists to get results much more quickly than they usually would.