Men with advanced prostate cancer may take chemo ‘breaks’

Oregon Health & Science University Cancer Institute, Portland, researchers have found that even men with advanced prostate cancer can take a safe and much-needed break from chemotherapy.

Researchers say their double-blind, randomized study, published in Cancer (2008; 112:326-30), is the first multi-institutional trial to examine outcomes from intermittent chemotherapy. A total of 250 men participated. Of those, 18% entered the intermittent arm of the study. These men previously had responded well to chemotherapy.

“We wanted to see if we could improve the quality of life for these patients by giving them time away from chemotherapy and possibly extend the time their cancer is controlled,” said lead author Tomasz Beer, MD. “Essentially, what we proved is that in selected subjects, chemotherapy holidays are feasible and provided meaningful breaks from treatment.”

The median duration of the first chemotherapy holiday was 18 weeks. On resumption of chemotherapy, the majority of subjects responded to treatment. Specifically, 45.5% of participants responded with a greater than 50% reduction in PSA from their post-holiday baseline; of those, 45.5% had stable PSAs for at least 12 weeks, and 9.1% developed disease progression.

The next step, Dr. Beer said, is to study the addition of immunotherapy during the chemotherapy holidays.