Three-drug cocktail ‘improves survival rates’

Mar 2022

A major new study highlights the benefits of using three, rather than two, proven drugs in combination

Giving men with advanced prostate cancer a combination of three different drugs instead of two could significantly improve their chances of survival, a major study shows. 

Currently, doctors usually treat advanced prostate tumours – those which have spread beyond the prostate – with two types of medicine. 

One is an androgen-deprivation drug which reduces levels of the hormone testosterone in the body. An example would be Zoladex (also known as Goserelin). Prostate cancer cells need testosterone to grow. 

To this, doctors either add another testosterone-suppressing drug, called an androgen-receptor pathway inhibitor, a chemotherapy medicine called Docetaxel. Chemotherapy’s job is to try and kill cancer cells and at least slow the tumour’s progression.

What’s not been clear until now is whether there was any additional benefit from giving all three together, rather than just two. Previous studies looking into this proved inconclusive. 

To get a clearer picture, researchers at Massachusetts General Hospital studied 1,306 men with advanced prostate cancer and split the group in two. 

Half got the two drugs already routinely used – an androgen deprivation medicine and chemotherapy – along with a placebo, or dummy, tablet. 

The rest got the same two drugs but also an extra dose of a medicine called Darolutamide, a type of androgen-receptor pathway inhibitor, which works by blocking the effects of testosterone on prostate cancer cells, stopping the hormone from fueling tumour growth. 

The drug is not a cure for prostate cancer but has been shown to postpone the spread of the disease.  It is currently given to men whose prostate cancer has stopped responding to other types of hormone therapy.

Each patient was followed up for three-and-a-half years and the results, published recently in the New England Journal of Medicine, showed the three-drug group had a 32.5 per cent lower risk of dying from their cancer during that period. Crucially, adding an extra medicine to their regimen did not appear to increase side-effects, researchers said. 

The findings are being seen as good news for men and scientists hope the three-in-one therapy will buy many men more precious extra time with their families and loved ones. 

‘This is an important step forward,’ said Dr Matthew R. Smith, an associate professor of medicine at Harvard Medical School and leader of the research team. ‘This should become the standard of care for these men.’ 

A Prostate Cancer UK spokesman added: ‘Adding Darolutamide to the treatment could give men with advanced prostate cancer even longer life expectancy. ‘We must now learn quickly which men respond best to this triple therapy so we can maximise the benefit of this and other new treatment combinations.’ 

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