Prostate cancer patients could be saved from chemotherapy after new research finds a way to “treat smarter, not harder.”
Scientists from University College London (UCL) found that chemotherapy is significantly more effective for some men with advanced prostate cancer than others.
Treatment is usually offered to all men diagnosed with advanced prostate cancer, in addition to hormone therapy.
About 47,500 men are diagnosed with the cancer each year, with 6,000 cases classified as advanced.
But the new research, presented at the American Society of Clinical Oncology’s annual conference in Chicago this month, found that some men with advanced-stage prostate cancer don’t benefit at all from chemotherapy.
Those who had a large number of metastases — secondary tumors — when they were diagnosed, and those who had larger tumors, benefited more from chemotherapy than those who received hormone therapy alone.
After five years, 38 percent of men with high metastases who received docetaxel — the most common form of chemotherapy for prostate cancer — were alive, compared with 26 percent who received hormone therapy alone.
Of those who had larger tumors, 58 percent survived for five years, compared with 19 percent with hormone therapy alone — a 39 percent increase.
But men with fewer metastases who had been diagnosed with the tumor at an earlier stage had no benefit at all from chemotherapy.
During the pandemic, docetaxel was less commonly prescribed in favor of newer hormone therapies, due to the potential impact of chemotherapy on the immune system.
Data from the National Prostate Cancer Audit shows a 74 percent decrease in the number of men with hormone-sensitive metastatic cancer who receive docetaxel between April and December 2020.
This research will help doctors target chemotherapy to those who will experience the most benefits, while allowing others to receive alternative, life-prolonging treatments that help them avoid the negative side effects.
Patients undergoing chemotherapy often experience nausea, hair loss, fatigue, loss of appetite, and infections.
dr. Claire Vale, author of the study and Principal Research Fellow at the Medical Research Council Clinical Trials Unit, University College London, said: “It is extremely rare to find such clear links between patient characteristics and how effective their treatment will be. In this case, the evidence is clear and we want to make sure it gets incorporated into clinical practice as soon as possible.”
dr. Hayley Luxton, Research Impact Manager at Prostate Cancer UK, said: “This is really exciting because it shows exactly how we can ‘treat smarter, not harder’ and get the most out of existing prostate cancer treatments. †
