Johns Hopkins Kimmel Cancer Center clinicians were among those at leading institutions that have completed a three-year international study showing that docetaxel, a drug made from yew tree needles, decreases the chance of dying by 24 percent in advanced-stage prostate cancer patients resistant to hormone therapy. Scheduled for presentation at the 40th annual meeting of the American Society of Clinical Oncology in New Orleans on June 7, the results spur hopes that earlier use of the drug alone or together with other agents will provide longer improvements in survival.
"This is good news for our prostate cancer patients," says Mario Eisenberger, M.D., co-chair of the study and the R. Dale Hughes Professor of Oncology at the Johns Hopkins Kimmel Cancer Center. "These data indicate that the current standard of care for these patients should be docetaxel therapy, and we should try adding new agents to build upon this success and test it in patients with aggressive disease before the cancer spreads."
Eisenberger co-chaired the global study that enrolled patients in 24 countries. With colleagues from Erasmus University in the Netherlands and Princess Margaret Hospital in Toronto, the research team randomly assigned 1,006 hormone-resistant prostate cancer patients to receive intravenous docetaxel (every three weeks or weekly) or the current standard chemotherapy drug, called mitoxantrone, which is approved mainly for reducing pain associated with tumor spread. Patients receiving docetaxel
every three weeks survived 2.4 months longer on average than those receiving mitoxantrone or docetaxel weekly.
"The study's statistics are very robust. Two months may not sound like much time to most people, but the study shows that prostate cancer responds to docetaxel and this opens up the door to explore more options," says Eisenberger. The study results also show significant improvements in pain
relief and lowering prostate specific antigen blood levels.
Side effects like low blood counts, fever, hair loss and nausea were seen more often in 25 percent of patients on the tri-weekly regimen of docetaxel, but many of the side effects are manageable, according to the study authors. All study participants received prednisone to improve symptoms.