Preliminary results indicate that giving men chemotherapy with a particular drug before hormonal therapy may potentially be an effective strategy in treating prostate cancer that has come back following surgery or radiation therapy. Results of the study, which is using the chemotherapy agent docetaxel, were presented today at the American Urological Association's annual meeting in Anaheim, CA, by oncologists at the University of Maryland Greenebaum Cancer Center in Baltimore.
"Traditionally, chemotherapy is not used for this group of patients. It is often reserved for men who have advanced, metastatic prostate cancer, following hormonal therapy," says Arif Hussain, M.D., a prostate cancer specialist at the University of Maryland Greenebaum Cancer Center and an associate professor of medicine and biochemistry at the University of Maryland School of Medicine. "In this study, we are reversing the order of treatment for men with early recurrent prostate cancer by giving them chemotherapy first, followed by hormone therapy."
The ongoing, phase II study has evaluated 26 patients so far. Researchers have found a 57 percent decline in levels of prostate-specific antigen, known as PSA, among the patients who completed chemotherapy before starting hormonal therapy. An increase in PSA levels often indicates that the prostate cancer is coming back.
"All of the patients treated with chemotherapy went on to respond to the hormone therapy, and we believe that such a combination could possibly be more effective in controlling recurrent prostate cancer," says Dr. Hussain.
The University of Maryland Greenebaum Cancer Center is currently one of only two centers studying this type of strategy. The other is the University of Massachusetts.
"Overall, the regimen has been well tolerated," says Dr. Hussain. "The preliminary results of this trial suggest that docetaxel followed by hormone therapy could represent a new treatment approach in men whose prostate cancer has recurred after surgery or radiation therapy, as evidenced by a rising PSA level."
The drug docetaxel is currently used to treat other cancers, such as lung and breast cancer.
"Unfortunately, most advanced prostate cancers develop resistance to traditional therapies over time. By using chemotherapy first in patients with early, recurrent disease, we may be able to more effectively kill prostate cancer cells before they develop resistance, and that is the rationale behind this new approach," says Dr. Hussain.