Prostrate Cancer & Abiraterone

05 Jun 2017

Scientists are hailing a breakthrough treatment for prostate cancer which promises hope for more than 20,000 men after proving suggestion of adding the controversial drug abiraterone to standard hormone therapy will double life expectancy in those with the most advanced form of the disease and “effectively cure” it many less critical patients.

 Men whose prostate cancer has spread can currently expect to survive around 3.5 years, however under the new strategy this is expected to become seven.

It also cuts by 50 per cent the traumatic bone complications that often accompany late-stage prostate cancer, an advance which should save the NHS £45 million annually.

The results, announced at the American Association of Clinical Oncology conference in Chicago, are relevant to roughly half the 40,000 men diagnosed with prostate cancer in England each year. Currently health chiefs only prescribe abiraterone to patients where the disease has spread and who are no longer responding to standard treatment. But in the new 2,000-patient trial, believed to be the largest ever of its kind, doctors combined the hormone regime, known as androgen deprivation therapy, alongside abiraterone in the first instance. The potential benefits of giving some men abiraterone alongside hormone therapy are clearly impressive Dr Iain Frame. Androgen deprivation therapy slows prostate cancer by preventing testicles from producing testosterone and other similar hormones which fuel tumour growth, but it cannot prevent other glands such as the prostate to continue making them.

By contrast, abiraterone is able to stop the production of both testosterone and other androgens throughout the body by targeting the crucial enzyme that converts the hormones.

“These are the most powerful results I’ve seen from a prostate cancer trial – it’s a once-in-a-career feeling,” said Professor Nicholas James, chief investigator on the Cancer Research UK-funded trial.

“This is one of the biggest reductions in death I’ve seen in any clinical trial for adult cancers.”

Around half the men diagnosed with prostate cancer are not immediately prescribed any treatment – instead their slow-growing tumours are regularly monitored as part of a “watch and wait” strategy.

But of the approximately 20,000 men in England who do require immediate treatment, 5,000 are diagnosed when the disease has already spread and cannot be cured. Another 5,000 patients currently die a year whose cancer metastasises after diagnosis. Before today, life expectancy for this group had only improved one year over the past decade. Professor James, Professor of Clinical Oncology at Birmingham University, said the projection of seven years life expectancy with abiraterone was “enormously exciting”.

He added that for those patients diagnosed with prostate cancer when the disease is confined to the pelvic area, most could expect to live as long as they would as if they were cancer-free.

The trial showed that after three years, fewer than five per cent of these patients had relapsed compared to 25 per cent just on androgen deprivation therapy.

He revealed that NICE is already considering the results of the STAMPEDE trial, and said that, although arbiraterone undoubtedly offers value for money, it may place too heavy a burden on NHS budgets to be recommended for all type patients it could benefit.

The organisation was heavily criticised for taking three “tortuous” years before agreeing to licence the drug in its current use in 2016, before which bosses had insisted patients first undergo gruelling rounds of chemotherapy.

NICE has not revealed what price it pays for the drug, which is manufactured by Janssen Biotech.
Dr Iain Frame, Director of Research at Prostate Cancer UK said: "These results are further evidence that earlier, combined use of existing treatments can improve the survival of men diagnosed with advanced prostate cancer.

“The potential benefits of giving some men abiraterone alongside hormone therapy are clearly impressive and we will be working with all relevant bodies to make sure this treatment becomes an option available for these men via the NHS."

Reference:  https://sg.yahoo.com/news/apos-enormously-exciting-apos-prostate-120448442.html