Targeting Occult Cancer Cells in High-risk Prostate Cancer Patients
Name of the Trial
Why This Trial Is Important
Doctors want to improve their ability to identify prostate cancer patients who fall into this high-risk group (i.e., men who have less than a 60 percent chance of remaining recurrence-free 5 years after treatment). One way to identify these patients takes into account factors such as tumor stage, higher levels of prostate-specific antigen (PSA), and other clinical signs, such as a higher Gleason score. However, said Dr. Eastham, "Once we identify them, there is no accepted treatment strategy for high-risk patients."
Some high-risk patients elect treatment before surgery (neoadjuvant therapy) in hopes of improving their long-term outcome. If their cancer's growth is dependent upon male hormones (androgens), anti-androgen therapy before surgery can reduce the extent of their disease. If their cancer is androgen-independent, systemic chemotherapy with a taxane drug has been shown to improve long-term survival.
In this trial, patients classified as high risk will be randomly assigned to undergo a course of neoadjuvant therapy or proceed directly to surgery. The neoadjuvant therapy will involve up to 18 weeks of docetaxel chemotherapy combined with hormone-depriving therapy using one of two drugs, either goserelin or leuprolide acetate, for 18-24 weeks. The idea, said Dr. Eastham, is to target two different populations of cancer cells that might separately be sensitive to each of these different approaches. "If such a strategy were effective, it could significantly change clinical practice."
For More Information
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