The prostate is a small gland present below the urinary bladder. This gland, only found in males, helps in making semen. Uncontrolled growth of cells in the prostate gland results in prostate cancer.  Cancer of the prostate gland is the second most common cancer in males. It is a slow-growing tumor mostly affecting elderly adult males. Since prostate gland is a part of the male reproductive system, prostate gland cancer affects the production of the male androgenic hormones.

The male testosterone is one of the androgenic hormones that enhance the growth of prostate cancer cells. Therefore, if the cancer cells are deprived of testosterone or other androgenic hormones, cancer cell growth will decrease. Androgen deprivation therapy is the mainstay of prostate cancer treatment, apart from combination treatments using surgery, radiation therapy, and chemotherapy. A recently discovered drug called “Abiraterone,” which stops the production of androgenic hormone throughout the body has been used in prostate cancer treatment.

In a one of a kind clinical trial (STAMPEDE trial) conducted in the United Kingdom and Switzerland, researchers found promising evidence for Abiraterone therapy against prostate cancer. The study recruited nearly 2,000 men with high-risk and advanced stages of prostate cancer. The study participants were randomly divided into two groups, to receive either a standard therapy or standard therapy plus Abiraterone.

The study found that after a median follow-up of 40 months, there were 262 deaths in standard therapy group compared to 184 deaths in the Abiraterone group. The 3-year survival rate was seven percentage points more in the Abiraterone group compared to standard therapy (83% Vs 76%). Abiraterone also decreased the relative chance of treatment failure by 71% compared to standard therapy, and this was consistent across all the sub-groups. Although severe side effects were more common in the Abiraterone group, the overall side effects were similar in both the groups. The major side effects of Abiraterone were high blood pressure, cardiovascular disease, liver abnormalities, and others.

The lead author of the study Dr. Nicholas James said that “Abiraterone not only prolonged life but also lowered the chance of relapse by 70% and reduced the chance of serious bone complications by 50%.” He also added that “based on the magnitude of clinical benefit, we believe that the upfront care for patients newly diagnosed with advanced prostate cancer should change.”

Three previously conducted clinical trials using a chemotherapeutic agent “Docetaxel” also found comparable results as Abiraterone. Further research can help clarify the benefits of using a combination of these two drugs on prostate cancer. Researchers are now planning for a molecular level analysis to find out the benefits of Docetaxel and Abiraterone.

 

Written by Krish Tangella MD, FCAP

References: 

1. Abiraterone Slows Advanced Prostate Cancer, Helps Patients Live Longer [Internet]. ASCO. 2017 [cited 2017 Jun 27]. Available from: http://www.asco.org/about-asco/press-center/news-releases/abiraterone-slows-advanced-prostate-cancer-helps-patients-live
   
2. About Prostate Cancer [Internet]. [cited 2017 Jun 27]. Available from: https://www.cancer.org/cancer/prostate-cancer/about.html