Hormone therapy gives men at high risk for prostate cancer a better chance of survival

Hormone therapy prevented one trial participant from developing metastatic disease 10 years after treatment.

Chris Arnold 3 minute read January 21, 2022
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In total, research was collected from 17 clinical trials, 42 collaborators, 703 medical centres, and more than 15,000 patients. GETTY

A form of hormone therapy could be more effective than radiotherapy for treating prostate cancer, researchers from University Hospitals and Case Western Reserve University in Cleveland, Ohio, say. 

For the last four decades, researchers have been monitoring the impact of hormone therapy on cancer patients, with varying results. The study was published this week in the journal The Lancet Oncology.

“Our research team set out to conduct a first-of-its-kind, comprehensive analysis by collecting individual patient data from each and every randomized trial conducted around the world, and performed a meta-analysis of the impact of various treatment intensification strategies using hormone therapy with radiation therapy for localized prostate cancer,” senior author Daniel E. Spratt said in a statement. “Our goal is to better personalize therapy for prostate cancer patients, by providing the most precise and accurate estimates of the benefit of hormone therapy.”

For the hormone therapy to be most effective, it must be taken in conjunction with radiotherapy.

The team found three key points of interest: men who are at high risk for prostate cancer have a better chance of survival when using the hormone therapy, no matter their age or the amount of radiotherapy they had taken already; the survival rate of men with prostate cancer improved with prolonged hormone therapy in addition to traditional radio therapy; and the time taking hormone therapy prior to radiotherapy had no benefit to patients. 

That last point is especially important, since some countries regularly provide hormone therapy before starting radiotherapy. 

“We now have estimates that show the benefit of adding and prolonging adjuvant hormone therapy for clinically relevant subsets of patients,” Spratt said “Our team showed that treating a group of approximately ten to 15 men with hormone therapy or extended adjuvant hormone therapy, for at least 18 months, prevented one man from developing metastatic disease 10 years after treatment. This is dependent on patient and tumour specific factors, but gives us a more precise estimate to work with when it comes to recommending treatment options.”

Prostate cancer one of the most common types of cancer in men

Prostate cancer is one of the most common types of cancer in men, with one out of every nine men being diagnosed in their lifetime, according to the Canadian Cancer Society. In 2020, more than 23,000 men were diagnosed with prostate cancer in Canada, the federal government says. The odds of being diagnosed go up with age, as well, with 99 per cent of cases reported in men aged 50 or older. 

This is the first ever comprehensive international collaboration of randomized phase three clinical trial individual patient data, the Meta-Analysis of Randomized Trials in Cancer of the Prostate Consortium (MARCAP), says. 

In total, research was collected from 17 clinical trials, 42 collaborators, 703 medical centres, and more than 15,000 patients. 

The organization, which was founded in 2020, aims to provide patients with evidence for the optimal treatment of prostate cancer. 

“This work from the MARCAP consortium will bring confidence in recommending various treatment intensification strategies, and allow providers to have more accurate, shared-decision making conversations with patients about the benefits of using hormone therapy with radiotherapy for prostate cancer treatment,” Spratt said. 

Researchers are not yet sure what causes prostate cancer, but there are a few factors that could put people at increased risk, the American Cancer Society says, namely mutations in genes. Roughly one-fifth of all malignant tumors in humans are caused by these genes, according to the National Center for Biotechnology Information.

Chris Arnold is a Toronto-based freelance writer. 
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