Studies show promise for treating biochemical recurrence of prostate cancer

The results of two new clinical studies offer hope for men who experience biochemical recurrence after primary treatment for prostate cancer. Both are scheduled for publication in the March Journal of Urology.

In the first, a double-blind, placebo-controlled multicenter study, researchers investigated the addition of thalidomide (Thalomid) to intermittent androgen deprivation therapy (ADT). Patients were first given ADT for 6 months, followed by thalidomide or placebo until their PSA increased. The median time to PSA increase was 15 months for the thalidomide patients versus 9.6 months for placebo. In a second phase, patients received another 6 months of ADT followed by thalidomide and placebo, now switched between patient groups. During this second phase, the median time to PSA increase was 17.1 months for thalidomide and 6.6 months for placebo.

“Thalidomide is associated with an increase in PSA progression-free survival in men with biochemically recurrent prostate cancer after intermittent ADT,” said lead author William D. Figg, PharmD, of the National Cancer Institute. “These effects were independent of any effects on testosterone.”

When data were analyzed in 2008 after an average 12.7-year follow-up, radiation was found to significantly reduce the risk of metastases by 29% and significantly improve survival by 28%. In addition, the risk of a detectable PSA after surgery was reduced by 58% and delayed by more than 7 years.

“Adjuvant radiotherapy within 18 weeks after radical prostatectomy in a man with pT3N0M0 prostate cancer significantly reduces the risk of PSA recurrence, metastasis, and the need for hormonal therapy, and significantly increases survival,” said lead author Ian M. Thompson, MD, of the University of Texas Health Science Center, San Antonio. “All of the approximate 30,000 men each year that face this condition should be informed of the results of this study.”