Newer drugs are improving survival for men with metastatic prostate cancer

Charlie Schmidt

Editor, Harvard Medical School Annual Report on Prostate Diseases

Treatments for advanced prostate cancer that’s metastasizing, or spreading in the body, are getting better, and men with the disease are living longer because of them, new research has found.

For years, the only available treatments for these aggressive tumors were androgen-deprivation therapies (ADT) that block testosterone, the male sex hormone that makes prostate cancer cells grow faster. Giving ADT slows cancer progression, but tumors typically develop resistance against it within three years and start growing again.

But then newer treatments for metastatic prostate cancer started showing up. A drug called docetaxel was approved by the FDA in 2004, followed by cabazitaxel in 2010, sipuleucel-T in 2011, abiraterone in 2011, and enzalutamide in 2012. Each of these drugs targets metastatic prostate cancer in different ways, and men who took any one of them in clinical trials lived longer than men who took ADT by itself.

For the current study, researchers set out to answer a unique question. They wanted to know if the combined market availability of these drugs was making a survival difference for men being treated for metastatic prostate cancer in the general population.

To find out, they divided men tracked by a national cancer registry into two groups. One group of 4,298 men had been diagnosed with metastatic prostate cancer between 2004 and 2008, and another equally sized group was diagnosed with the disease between 2009 and 2014. All the men in both groups were matched in terms of age, race, cancer stage at diagnosis, treatment, and other factors.

Results showed that the duration of survival before men died specifically from prostate cancer lasted approximately 32 months among those diagnosed during the earlier time frame, and 36 months among those diagnosed during the later one. Similarly, the duration of survival before men died from any cause after a metastatic prostate cancer diagnosis was 26 months between 2004 and 2008, and 29 months during the 2009–2014 time frame.

The authors acknowledge that the survival improvements are modest, but add they may not fully account for longer survival improvements from abiraterone and enzalutamide, which only came into widespread use at the end of the study period. Furthermore, men who respond extraordinarily well to the new treatments may live far longer than those who don’t. In general, the evidence provides “valid evidence in support of [newer] novel treatments,” the authors wrote.

Dr. Mark Garnick, the Gorman Brothers Professor of Medicine at Harvard Medical School and Beth Israel Deaconess Medical Center, and editor in chief of HarvardProstateKnowledge.org, says, “This study provides important information that men with advanced forms of prostate cancer are now living longer than they once did, sometimes years longer. Those of us who have been treating prostate cancer for decades appreciate this study’s fundamental finding that the improved longevity from newer cancer drugs is considerable.”

Comments:

  1. Gregory

    I had to deal with an enlarged prostate for years, I started having prostate symptoms since my middle 40s, I am 51 years old now and after trying with different methods and drugs I was really disappointed but while I was talking with one of my coworkers he told me about his experience with a supplement that helped him with his prostate problems, its named alpharise, since I tried with many things, different drugs and supplements before this one, I didn’t have big expectations about it but I was surprised after a few weeks because I noticed some changes, it’s been 4 months already and I am really happy with this supplement, it really works.

  2. joseph cannatelli

    Question Newer drugs are improving survival for men with metastatic prostate cancer

    Were these patients just given drug therapy or adjunct to operation/radiation/chemo

    What was quality of life in both cases? was second group in better condition before dying or did both groups go into bad stage of suffering foor same lenght of time.

    If life is extended 3 months in same dplorable state then why live longer.Quality of extended life should be a major consideration more so than just longer.

    I do appreciate living longer affords the chance to be alive when new/better meds/cures become available and that can be addressed too

    Thank you for this article and others in your newsletter

  3. Jack Davidson

    I have been on Xtandi Enzalutamide since 2013 . My PSA has been under 1 since also Bone Scan & Cat Scan shows no trace of a spread.
    My cancer was 1st Diagnosed in 2004 and treated in 2005 with seed implants but PSA started to rise 2008. I then went on PSA blocker but not Chemical Castration until 2013 then luckily was passed on to Xtandi without going thru Chem. Castration or Chemo Therapy. I feel those with P.C. Should be eligible for the best treatment without going thru several debilitating steps before eligibility. As a working Actor diagnosed when I was 69 I have been able to work and still am working in my Profession as I approach my 82nd Birthday.