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While debate rages over how aggressively to treat early-stage prostate cancer, men with advanced metastatic disease could gain a year of life if they receive a chemotherapy drug soon after their diagnosis rather than receiving the drug after hormonal treatments have lost their effectiveness, a new Dana-Farber Cancer Institute study finds. Researchers from Dana-Farber and other cancer centers tested both methods in 790 men diagnosed with end-stage prostate cancer that had spread to other organs and was dependent on hormones to grow. The group that received hormone therapy along with the chemotherapy drug docetaxel (Taxotere) lived for nearly 58 months on average compared with 44 months for those who initially received only the hormone therapy.


The chemotherapy treatment also delayed disease progression, which was monitored by an increase in prostate-specific antigen (PSA), the appearance of new metastases, or a worsening of symptoms. The men who received docetaxel as a first-line therapy had an average of nearly 33 months before the cancer progressed, compared with nearly 20 months for those who did not get the drug initially, according to the study, which was presented last Sunday at the annual meeting of the American Society of Clinical Oncology in Chicago.

“The benefit is substantial and warrants this being a new standard treatment for men who have high-extent disease and are fit for chemotherapy,” said Christopher Sweeney of Dana-Farber’s Lank Center for Genitourinary Oncology. D.K.