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    Early chemo-ADT combination may be new PCa standard

    A new study showing a survival benefit of more than 1 year with a chemotherapy-hormonal therapy combination given prior to castration resistance is being hailed by the study’s first author as a “new standard” of treatment for certain men with metastatic, hormone-sensitive prostate cancer.

    Other experts in prostate cancer are calling the study findings a “home run” and potentially practice changing.

    The study, from Dana-Farber Cancer Institute in Boston and the Eastern Cooperative Oncology Group, was presented on Sunday at the American Society of Clinical Oncology annual meeting in Chicago.

    “This is the first study to identify a strategy that prolongs survival in newly diagnosed, metastatic prostate cancer,” said Christopher J. Sweeney, MBBS, of Dana-Farber’s Lank Center for Genitourinary Oncology.

    “The benefit is substantial and warrants this being a new standard treatment for men who have high-extent disease and are fit for chemotherapy,” added Dr. Sweeney, principal investigator of the E3805 National Cancer Institute-funded study.

    The trial tested the hypothesis that immediately treating metastatic, castration-resistant prostate cancer (mCRPC) with chemotherapy in addition to androgen deprivation therapy (ADT) would impair the tumor cells’ ability to repair damage, delaying the development of resistance.

    A total of 790 men newly diagnosed with metastatic disease were enrolled and were randomized to receive ADT alone or ADT with docetaxel (Taxotere) over 18 weeks. In the ADT-only group, 124 patients were given docetaxel when their cancer worsened. In the ADT-plus-docetaxel group, 45 patients whose disease progressed received additional docetaxel.

    At a median follow-up of 29 months, 136 patients in the ADT-only group had died versus 101 in the group that received both drugs. This translated into a median overall survival of 57.6 months for men who received early chemotherapy compared with 44 months in the group given ADT as the only initial treatment— more than a year of additional life, according to a Dana-Farber statement.

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