Golden age of prostate cancer treatment hailed as fourth drug in two years extends life

A study in the New England Journal of Medicine today shows the drug enzalutamide can significantly extend life and improve quality of life in men with advanced prostate cancer – in findings that could further widen the treatment options for men with the disease.

The Institute of Cancer Research, London, and its partner hospital The Royal Marsden NHS Foundation Trust jointly led the new Phase III trial of enzalutamide and the Phase III trials of two other drugs, cabazitaxel and abiraterone. Abiraterone was also discovered at The Institute of Cancer Research and was recently made available on the NHS. A further drug sipuleucel-T has also been shown to extend life in the two-year period.

Professor Alan Ashworth, chief executive of The Institute of Cancer Research (ICR), said cancer research in the UK was finally delivering new treatment options for men with advanced prostate cancer after a long period where the options were limited.

Professor Ashworth said: "Advanced prostate cancer is extremely difficult to treat, and it's taken a massive coordinated effort to finally bring new drugs into the pipeline, after decades where there were no options once old-style hormone treatment stopped working.

"What we're seeing now is an unprecedented period of success for prostate cancer research, with four new drugs shown to extend life in major clinical trials in just two years, and several others showing promise. It truly is a golden age for prostate cancer drug discovery and development."

Professor Martin Gore, medical director of The Royal Marsden Hospital, said: "We are delighted with the recent progress that has been made in the treatment of advanced prostate cancer and to see the impact this is having on our patients, many of whom are living longer with a better quality of life as the result of these new drugs."

Enzalutamide, a new type of hormone treatment, was assessed in 1,199 patients with metastatic castration-resistant prostate cancer that had previously received chemotherapy, in a multinational, randomised placebo-controlled trial sponsored by pharmaceutical companies Medivation and Astellas.

Median survival with enzalutamide was 18.4 months, compared with 13.6 months for men receiving a placebo. Around 43 per cent of men taking enzalutamide as part of the AFFIRM trial reported an improved quality of life, compared with 18 per cent of men taking a placebo. In November last year, the trial's Independent Data Monitoring Committee recommended that the trial be stopped early and men who received the placebo be offered enzalutamide.

The Phase III trial was jointly led by Professor Johann de Bono, head of the Drug Development Unit at the ICR and The Royal Marsden.

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Standard treatment for men with advanced, castration-resistant prostate cancer is the chemotherapeutic drug docetaxel (Taxotere), which was approved in 2004. In 2010, the results of a Phase III trial showed the drug sipuleucel-T (Provenge) could also extend life for patients who are no longer responding to docetaxel, leading to the drug's approval in the US. Cabazitazel followed later in 2010, abiraterone in 2011 and enzalutamide today. Cabazitaxel and abiraterone are available in the UK.

An interim analysis of a Phase III trial that the ICR and The Royal Marsden are co-leading for the drug radium-233 choloride (Alpharadin) has also shown an increase in overall survival compared to a placebo, although the final analysis has not yet been published.

Journal reference: New England Journal of Medicine

Provided by Institute of Cancer Research