Which patients with advanced prostate cancer will benefit from chemotherapy

Researchers have recommended changes to how cancer patients are treated, after a new UCL-led study discovered that chemotherapy is significantly more effective for some men with advanced prostate cancer than others. On average, docetaxel chemotherapy improved 5-year survival by 10% compared to standard hormone therapy, which works by reducing the levels of male hormones in the body to stop them from reaching the cancer cells. And both treatments may be offered to all men diagnosed with advanced prostate cancer. However, the research, which was presented at the American Society of Clinical Oncology (ASCO) and funded by Prostate Cancer UK, found that men who had many metastases (secondary cancer tumours) when they were diagnosed benefitted most from docetaxel chemotherapy, with 39% surviving five years, compared to 26% who had hormone therapy alone. Among those with many metastases who also had larger prostate tumours, 55% survived for five years after having the treatment, compared to just 20% of men who just had hormone therapy. In this study, those with many metastases or "high volume" metastatic disease, had either four or more secondary tumours in the bones and/or any metastasis in an organ such as the liver or lungs. Meanwhile, men with fewer than 4 bone metastases ("low volume") and who had been diagnosed with prostate cancer at an earlier stage, did not benefit from docetaxel chemotherapy at all.