Adding targeted therapy to hormone therapy may eliminate prostate tumors pre-surgery

Six months of treatment with the targeted androgen biosynthesis inhibitor abiraterone (ZYTIGA), in addition to standard hormonal therapy before prostatectomy, eliminated or nearly eliminated cancer in one-third of men with localized high-risk prostate cancer, a recent study found.

The randomized phase II study marks the first time that abiraterone has been explored for the treatment of earlier stages of prostate cancer, including in the neoadjuvant setting.

"For this proportion of patients with high-risk disease to have very little to no detectable cancer in the prostate after 6 months of therapy is dramatic," said lead author Mary-Ellen Taplin, MD, of Harvard Medical School and the Dana-Farber Cancer Institute, Boston. "Our findings suggest that this combination therapy approach could improve outcomes for a substantial number of men, but larger, long-term trials are needed to confirm this approach."

The study, which was presented at the American Society of Clinical Oncology annual meeting in Chicago, evaluated the effect of adding abiraterone to leuprolide in two groups of men. Group A included 27 men who received leuprolide hormonal therapy for 12 weeks followed by leuprolide plus abiraterone for another 12 weeks. Group B included 29 men who received both abiraterone and leuprolide for the entire 24-week period. Prostate surgery was performed in all men after 24 weeks of therapy, and the tissue was examined for evidence of cancer.

Among men in group B, 34% had either complete elimination or nearly complete elimination of their cancer upon surgery. In group A, 15% of men had either complete elimination or nearly complete elimination of their cancer upon surgery. Therapy was well tolerated by both groups.

Dr. Taplin has a consultant/advisory role with and has received honoraria and research funding from Johnson & Johnson. Several of her co-authors have a consultant/advisory role; have received honoraria, research funding, and/or other remuneration; have an employment/leadership position; and/or own stock with Janssen Pharmaceuticals Inc. and/or Johnson & Johnson.

Look for additional coverage of the ASCO annual meeting in Urology Times and Urology Times eNews.

Go back to this issue of Urology Times eNews.