Combined with androgen deprivation therapy, two drugs, docetaxel and abiraterone, can prolong survival in patients with metastatic hormone-sensitive prostate cancer.
- When combined with two other drugs (abiraterone acetate and docetaxel), the standard treatment for metastatic forms of prostate cancer shows markedly superior results.
- This therapeutic combination allows an additional reduction of 25% in the risk of death compared to one of these treatments alone.
- The use of abiraterone acetate is also conclusive in non-metastatic prostate cancer considered to be persistent.
With 50,400 new cases of prostate cancer and 8,100 deaths estimated in 2018 in metropolitan France, prostate cancer remains the most common in men over 50.
Although the incidence rate and the mortality rate have tended to decrease in recent years, it still remains the 3rd most common cancer death in men. Hence the importance of developing new therapies that are more effective and capable of targeting aggressive cancer cells.
A new study, presented at the ESMO Congress 2021 shows that this new therapy could be the combination of androgen deprivation therapy (ADT), the standard treatment for prostate cancer, and three molecules already used, abiraterone acetate and prednisone (AAP ) and docetaxel.
18 months of life gained thanks to the therapeutic combination
For men with metastatic prostate cancer, androgen deprivation therapy (ADT) has been the standard of care for decades. Since 2015, a chemotherapeutic agent, docetaxel, has been regularly used in addition to ADT. In 2017, abiraterone (a next-generation hormonal agent) was also shown to improve survival when added to ADT. However, until now, it was unclear whether one or both agents should be added to ADT for best results.
This new work shows that a therapeutic combination of these three drugs not only delays cancer progression, but also prolongs patient survival. When abiraterone acetate and prednisone were added to ADT and docetaxel, men experienced an additional 25% reduction in risk of death compared to ADT and docetaxel alone.
According to the author of this study entitled PEACE-1, Pr Karim Fizazi, medical oncologist at the Gustave Roussy Institute and professor of oncology at the University of Paris-Saclay, this is the first trial “establish that triplet therapy should be offered to these men, especially those with the most aggressive cancers (those with multiple metastases)”.
This treatment has also enabled patients who have benefited from it to obtain 2.5 additional years without cancer progression and approximately 18 additional months of life. “Furthermore, the additional side effects associated with the triplet combination were mostly mild, with very few serious side effects”adds the researcher.
Conclusive results on non-metastatic cancers
Abiraterone acetate has also been proven in non-metastatic but high-risk prostate cancer, as shown by the results of a second study, called STAMPEDE. Conducted by researchers at University College London, UK, it shows that men who received standard therapy plus APA for two years had a 69% to 82% improvement in metastasis-free survival, an improvement in overall survival of 77% to 86% and an improvement in prostate cancer-specific survival of 85% to 93% – compared to standard therapy alone.
“Based on these results, all men with high-risk non-metastatic prostate cancer should be considered for two years of abiraterone. This will involve more hospital visits during this time to manage the administration of the drug, but by reducing subsequent relapses, it could reduce the overall burden on patients and health services.”said Professor Gerhardt Attard, lead author of the work.
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