Prostate news article, July 2007
| A SYSTEMATIC
REVIEW CONCLUDES THAT TREATMENT WITH ZOLADEX ® (GOSERELIN)
ALLOWS MEN WITH PROSTATE CANCER TO OUTLIVE THEIR DISEASE
Article published in Prostate Cancer and Prostatic Diseases
(2007) 1-7 Reported by: Dr Heather Payne Middlesex Hospital, London |
 |
Adjuvant goserelin therapy should be considered a curative treatment in a substantial proportion of patients with locally advanced prostate cancer
An AstraZeneca sponsored review published in Prostate Cancer and Prostatic Diseases reveal that goserelin given with radiotherapy or after radical prostatectomy (surgery), to treat men with locally advanced prostate cancer (when the cancer has spread into the capsule of the prostate or through the prostate into the surrounding tissues) can not only control the disease for a long period of time, but also allow men to outlive their disease(1). The report shows that men with locally advanced prostate cancer treated with adjuvant goserelin have a risk of mortality similar to the general population without prostate cancer and researchers conclude that adjuvant goserelin therapy should be considered a curative treatment in a substantial proportion of this patient population(1).
Findings come from a review of four randomised, controlled clinical trials investigating patients with locally advanced prostate cancer who received adjuvant hormonal therapy with goserelin following their primary treatment (radical prostatectomy or radiation therapy)(2)(3)(4)(5).
Commenting on the report, author Dr Heather Payne, Consultant Clinical Oncologist in Urological Tumours, University College Hospital, London stated: “A large body of clinical evidence exists to support the efficacy of goserelin in the treatment of prostate cancer, including data showing goserelin delays disease progression and improves survival. This exciting data provides evidence that adjuvant goserelin therapy can consistently allow patients to outlive their disease and essentially provide a cure for a substantial number of men with locally advanced prostate cancer.”
The introduction of goserelin transformed the treatment of prostate cancer as previously, men with prostate cancer faced surgical orchidectomy (an operation to remove the testicles). Despite evolving clinical practice and goserelin being launched 20 years ago, goserelin is still the standard hormonal treatment in the management of prostate cancer today.
Researchers reviewed goserelin as it is the most widely researched Luteinizing Hormone-Releasing Hormone agonist (LHRHa). The researchers assessed whether the potential for cure was achieved using an amended definition of cure specific to prostate cancer, defined as 1) when the disease-free survival curve flattens out after 10-15 years following treatment and 2) when the overall survival rate approaches that of an age-related healthy male population.
Across all four trials, long-term disease control was achieved in a sizeable proportion of men with locally advanced prostate cancer (defined as having PSA level >20ng/mL and high Gleason scores >8 amongst other criteria) who received adjuvant goserelin(1). The disease-free survival (Kaplan-Meier) curves flattened during long-term follow up, indicating that many men are not relapsing. Importantly, the overall survival curves indicate that patients were not experiencing significant additional mortality associated with the side-effects of long-term goserelin use(1).
London, 6th August 2007:
References:
1 - Fleshner N, Keane TE, Lawton CA et al. Prostate Cancer PD. 2007;
advance online publication
2 - Messing EM et al. Lancet Oncol 2006: 7; 472-79
3 - Pilepich et al, Int J Radiat Oncol Biol Phys 2005; 61: 1285 - 1290
4 - Bolla et al, Lancet 2002; 360:103-108
5 - Hanks et al, J Clin Oncol 2003; 21: 3972-3978
Prostate Cancer and Prostatic Diseases (2007) 1-7:
ORIGINAL ARTICLE: Adjuvant androgen deprivation therapy augments cure
and long-term cancer control in men with poor prognosis, nonmetastatic
prostate cancer. - N Fleshner(i), TE Keane(ii), CA Lawton(iii), PF Mulders(iv),
H Payne(v), SS Taneja(vi) and T Morris(vii)
(i) Division of Urology, Princess Margaret Hospital, Toronto, Ontario,
Canada
(ii) Medical University of South Carolina, Charleston, SC, USA
(iii) Medical College of Wisconsin, Milwaukee, WI, USA
(iv) University Hospital Nijmegen, Nijmegen, The Netherlands
(v) Meyerstein Institute of Oncology, Middlesex Hospital, London, UK
(vi) New York University School of Medicine, New York, NY, USA
(vii) AstraZeneca, Alderley Park, Macclesfield, UK