A breakthrough triple therapy for advanced prostate cancer can give patients years’ healthier life and reduces the overall risk of death by a third. The regime involves two standard therapies alongside a powerful new hormone medication, darolutamide.
The new drug has already proved to be effective as a standalone treatment in the earlier stages of the disease, when given to men who have stopped responding to other medications. But a pivotal trial has now shown that when combined with standard therapies it also has a dramatic effect in patients whose cancer has spread throughout the body.
Although a cure isn't possible for these men, using darolutamide, chemotherapy and other hormone medicines reduced pain, slowed the progression of the disease and extended survival. The men on the trial were mostly in their late 60s, although one patient was 89. Those given the new combination therapy went for four years before their cancer began to progress, while in patients given the standard treatments alone their cancer worsened after just six months.
Professor Alison Birtle, consultant clinical oncologist at Lancashire Teaching Hospitals NHS Foundation Trust, called the advance 'exciting'. She added: 'We've never had the option of a triple therapy like this before.
'This study provides a compelling argument to adding darolutamide to standard chemo and hormone treatment, as it will help men with advanced prostate cancer live longer, healthier lives, with less pain.' There are roughly 52,000 new prostate cancer cases every year in the UK.
For those men with earlier-stage disease, surgery is typically offered to remove the prostate – and tumour within – in the hope of a cure. If they reject surgery, which men often do as the procedure can lead to incontinence and erectile dysfunction, they are offered drugs to limit the amount of the male hormone testosterone they produce, which prostate cancers use to grow.
In 15,000 men a year the disease has already spread by the time they are diagnosed – and in many cases surgery is pointless. Instead, chemotherapy, radiotherapy and hormone drugs shrink tumours and keep the disease at bay for as long as possible.
But in incurable cases, most patients eventually become resistant to standard hormone drugs.
At this stage, the cancer is hard to control and men are unlikely to survive for long. While three-quarters of prostate cancer patients live for ten years or more, the disease still kills 11,000 a year.
Darolutamide works by binding to tumour cells, preventing testosterone from reaching them.
In 2020 the drug was approved for NHS use after showing success in treating men with early-stage prostate cancer that was resistant to the usual hormone drugs. But the new trial showed it also has a remarkable effect on those who may once have been considered lost causes.
A total of 1,306 newly diagnosed prostate cancer patients were split into two groups. Both were given the chemotherapy drug docetaxel and a standard testosterone-limiting therapy, but one group was given additional darolutamide, while the other was given placebo, or dummy tablets.
They were then followed for more than four years.
In the group given darolutamide there was a 32 per cent reduced risk of death and a 65 per cent increase in progression-free survival – the time before the disease begins to advance again.
One patient to have benefited from the triplet treatment is father-of-three and grandfather-of-nine Roger Downes, 78. The retired airport worker from Essex was diagnosed with advanced prostate cancer five years ago, after being rushed to A&E suffering pain in his groin and blood in his urine.
Scans showed the disease had already spread into his pelvis. He had eight weeks of chemotherapy along with standard hormone pills and darolutamide – and continued on the tablets after the chemo had finished. He has been on them ever since.
He said: 'The cancer has disappeared from my pelvis and I'm told my PSA levels are normal. 'Now I wake up and think, today is another good day. 'I take two pills every morning and two before bed. I play bowls, I walk a lot and I feel healthy.'
Source: Mail on Sunday