Prostate most cancers breakthrough means males may keep away from chemotherapy

Thousands of men a year with advanced prostate cancer could avoid gruelling chemotherapy by combining radiotherapy and hormone therapy, a study reveals.

Targeting the radiotherapy to the sites where the cancer has spread can delay further progression of the disease and the need for subsequent treatments, such as chemotherapy, which can have significant impact on a person’s quality of life, researchers say.

The trial demonstrated that the patients’ cancer did not progress for an average of six months (6.4) and two fifths (40.1 per cent) of patients remained progression-free at 12 months.

The research was led by The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, London, and presented today at The European Society for Radiotherapy and Oncology (ESTRO) annual congress.

The Phase II trial is the first prospective trial to investigate the use of stereotactic body radiotherapy (SBRT) in patients with hormone-resisistant oligoprogressive prostate cancer.

Targeting the radiotherapy to the sites where the cancer has spread can delay further progression of the disease and the need for subsequent treatments, such as chemotherapy, which can have significant impact on a person’s quality of life, researchers say

Oligoprogressive cancer occurs when cells from the original tumour travel within the body to fewer than three sites, forming new tumours or lesions.

Currently, disease progression after hormone therapy treatment is taken as a sign that the cancer has become resistant to the treatment.

However, findings from the trial revealed that it may just be some tumours that are resistant, and if the tumours are treated with radiotherapy the rest of the cancer will still respond to hormone therapy.

In the national study, which took place in cancer centres across the UK, researchers investigated whether giving SBRT along with a type of hormone therapy, called androgen receptor targeted agents, to patients with oligoprogressive prostate cancer would delay the time it takes for their cancer to progress.

The patients in the study had advanced prostate cancer that was no longer responding to regular treatment.

 More than 52,000 men are diagnosed with prostate cancer every year on average in the UK, making it the most common cancer in men. Around 12,000 men die every year from the disease — the equivalent of one every 45 minutes

They had no more than two new areas of cancer that had appeared while they were on two types of hormone therapy, after initially responding well to the treatment.

All the patients were treated with five or six treatments SBRT, which is painless and takes about 20-30 minutes for each treatment.

81 men received SBRT and most of them (67 per cent) had one oligoprogressive lesion. The areas treated were bone (59 per cent), lung (1 per cent), lymph node (32 per cent) and prostate (8 per cent).

At an average of 19.2 months, 53 (65 per cent) patients experienced progression of their disease; 32 (40 per cent) progressed within six months following SBRT treatment.

Median progression-free survival following SBRT was 6.4 months and 40 per cent of men had no evidence of cancer growth 12 months after treatment.

Researchers estimate around 2,000 to 3,000 men per year would meet the qualifying criteria above.