An international study led by a Canadian researcher shows that men with advanced, incurable prostate cancer can survive an average of three months longer and face less symptoms when offered a new treatment for prostate cancer.
Published in tomorrow's issue of The New England Journal of Medicine, the study involved 24 countries and over two years tracked more than 1,000 patients with advanced hormone-refractory prostate cancer. The patients were randomly divided into three groups, with one group receiving the standard chemotherapy (mitoxantrone), while the other two groups received docetaxel either every three weeks or weekly. All three groups received low daily doses of prednisone. Researchers looked at several outcome measures - survival, pain relief, improved quality of life, and the amount of PSA in the patients' blood, which indicates the amount of cancer present in the body. In all these measures, men who received docetaxel administered every three weeks did better than those who received mitoxantrone, and it improved survival by an average of three months. There was no significant difference in survival between those patients receiving docetaxel weekly and those receiving mitoxantrone.
"The new treatment of docetaxel results in many patients feeling better and living a few months longer," said Dr. Ian Tannock, the study's lead author and medical oncologist at Princess Margaret Hospital, senior scientist with Ontario Cancer Institute, and professor with the University of Toronto. "As a result, we are recommending docetaxel every three weeks with daily prednisone as the new standard of treatment for many patients with advanced hormone-refractory prostate cancer."
Prostate cancer is the most common cancer in men. One in eight Canadian men will develop the disease during their lifetime, and most cases are diagnosed in men over the age of 65. Initially, prostate cancer may be treated by surgery, removing the prostate gland, or by radiation therapy. In some cases, the cancer becomes metastatic, spreading to other parts of the body. It is then usually treated by measures that modify the body's hormones, since prostate cancer cells are stimulated to grow by male hormones such as testosterone. However, the cancer may eventually become resistant to hormonal treatment and patients might then benefit from chemotherapy. Docetaxel works by interfering with the cells' ability to divide. Currently used in some breast cancer and lung cancer patients, its side effects include changes in nails, tiredness, tingling and loss of sensation in fingers and toes. Docetaxel has been approved by the U.S. Food and Drug Administration.
This research was supported in part by Aventis, the company that manufactures Docetaxel.
Princess Margaret Hospital and its research arm, Ontario Cancer Institute, have achieved an international reputation as global leaders in the fight against cancer. Princess Margaret Hospital is a member of the University Health Network, which also includes Toronto General Hospital and Toronto Western Hospital. All three are teaching hospitals affiliated with the University of Toronto.