Patients with advanced prostate cancer treated with the latest therapies are living on average for more than twice as long as a decade ago, a striking new analysis reveals.
It showed that patients with incurable prostate cancer treated at leading cancer hospital The Royal Marsden NHS Foundation Trust now live for about two extra years on average than they did just 10 years ago.
The research, conducted by The Institute of Cancer Research, London, and The Royal Marsden, found the introduction of a range of new drugs has had such an impact that the system doctors use to predict how long patients will live now needs to be revised.
The research is published in the August issue of European Urology and was conducted by researchers who are funded by Prostate Cancer UK, Cancer Research UK, the Medical Research Council and the Prostate Cancer Foundation, US. The team studied data from 442 UK patients across 32 clinical trials and two extended access drug programmes at The Royal Marsden since 2003.
Some 78% of patients received docetaxel-based chemotherapy, which was approved for use on the NHS in 2005. Half (49%) received abiraterone, a targeted prostate cancer drug discovered at The Institute of Cancer Research (ICR) and approved for use on the NHS last year. Three other novel therapies – enzalutamide, cabazitaxel and radium – were used to treat a small minority of patients.
The researchers demonstrated that a patient with incurable, castration-resistant prostate cancer receiving a novel targeted therapy will live for around 41 months – just under three-and-a-half years – on average. This is up from an average of 13-16 months on average in the era before docetaxel-based chemotherapy.
Professor Johann de Bono, Professor of Experimental Cancer Medicine at The Institute of Cancer Research and Honorary Consultant in Medical Oncology at The Royal Marsden, said: “This analysis highlights the remarkable benefits we are seeing from new treatments for men with advanced prostate cancer. Put simply, men are living for much longer with incurable disease than they did a few short years ago. “Advanced prostate cancer is still incurable, but new treatments are giving men more time to do the things that matter to them with their loved ones. That couldn’t be more important and shows the strides we are making in the fight against the disease.” The research found that the models used to predict survival among men with metastatic, castration-resistance prostate cancer need to be updated to reflect the impact of new treatments such as abiraterone.
For example, the 238 patients who had not received chemotherapy before entering a clinical trial survived on average for 30.6 months, or about two-and-a-half years. The Halabi and Smoletz prediction models, both widely used by the NHS, predicted these patients would survive between 18 and 21 months, about nine to 12 months below the reality.
Professor Alan Ashworth, Chief Executive of The Institute of Cancer Research, said: “We are living through a remarkable period of progress against prostate cancer, with new drugs such as abiraterone transforming the prospects for men with advanced disease.
“It’s excellent news that men receiving these therapies at The Royal Marsden are living for so much longer than they would have been expected to do a decade ago. The study highlights too the benefits of being able to treat so many patients on clinical trials, expanding access to new drugs and accelerating their path to wider use on the NHS.”
Cally Palmer, Chief Executive of The Royal Marsden, said: “Over the last decade, there have been some exciting steps forward in the treatment of advanced prostate cancer, and we have pioneered use of many of the newest drugs here at The Royal Marsden.
“New treatment options developed through clinical trials are delivering real benefits for the quality of life of men with prostate cancer, with fewer of the side-effects associated with conventional chemotherapy."