Clinical trial finds combination hormone therapy delivers superior prostate cancer treatment

Combining testosterone-blocking medication in sufferers with prostate most cancers relapse prevents the unfold of most cancers higher than remedy with a single drug, a multi-institution, Part 3 scientific trial led by UC San Francisco researchers has discovered.

The method can prolong the time between debilitating drug treatments with out prolonging the time it takes to recuperate from every remedy.

Prostate most cancers impacts 1 in 8 males and causes 34,000 deaths every year in the US. It’s normally handled with one among a number of testosterone-lowering medication for a set time frame.

“This provides to a rising physique of proof in favor of extra intensive testosterone-blocking remedy in sufferers with higher-risk prostate cancer,” stated Rahul Aggarwal, MD, professor within the UCSF College of Medication and lead creator of the paper.

The researchers’ findings have been printed on Jan. 23, 2024, within the Journal of Scientific Oncology. They have been first introduced in September 2022 on the annual assembly of the European Society for Medical Oncology.

A case for intensifying prostate most cancers remedy

The brand new examine targeted on sufferers who had surgical procedure for prostate most cancers, and but the most cancers relapsed and was detected by a sudden soar within the blood ranges of a protein known as prostate-specific antigen (PSA).

“We checked out sufferers who had a quick rise of their PSA—an indicator of a higher-risk type of relapsed prostate most cancers,” Aggarwal stated. “Our aim was to check a number of totally different hormone remedy methods to search out the perfect method by way of delaying the most cancers’s development.”

Between 2017 and 2022, 503 sufferers have been randomly assigned to take a single testosterone-lowering remedy chosen by their oncologist, or to mix it with one or two different testosterone-lowering medication. The extra medication have been already FDA-approved for different cancers however hadn’t been examined on this approach with prostate most cancers.

The sufferers stayed on the assigned remedy for a 12 months. Whether or not given singly or together, the medication induced their testosterone to plummet. That put the brakes on their most cancers, but in addition induced fatigue, sizzling flashes, decreased libido and different issues for sufferers, based on Aggarwal.

In comparison with the prostate most cancers sufferers who solely acquired a single drug remedy throughout their 12 months of remedy, sufferers who acquired both one or two extra medication stayed cancer-free, with low PSA ranges, for longer.

As soon as off the remedy, sufferers who took the mix therapies noticed their testosterone levels recuperate simply as quick as others who took the only drug.

The researchers are following up with a extra detailed evaluation of how sufferers fared on the totally different therapies—which unwanted side effects they skilled and for the way lengthy, and the way they felt total as they recovered.

“New most cancers therapies should clear a excessive bar to make their solution to sufferers,” Aggarwal stated. “With the proof on this examine and others, mixture hormone remedy ought to be thought-about a typical of care in prostate most cancers sufferers with high-risk relapse after prior remedy.”