American Society of Clinical Oncology Annual Meeting Highlights he following study results were presented at the Plenary Session of the American Society of Clinical Oncology’s 50th Annual Meeting, held May 29 through June 2, 2014 in Chicago, Illinois. The Plenary Session featured the meeting’s most important clinical cancer research: that with the greatest potential to impact patient care.
stage, women in the control arm were 50% more likely to be alive after the initiation of treatment than those in the standard treatment arm. Although those results are encouraging, Dr. Moore says that more research is needed to understand any role of goserelin in the treatment of patients with estrogen receptornegative breast cancer.
Drug May Help Preserve Fertility in Women Undergoing Chemotherapy
Docetaxel Plus ADT Improves Survival for Some Patients with Prostate Cancer
Findings from a phase 3 clinical trial have shown that adding the hormone-suppressing drug goserelin to standard chemotherapy may help preserve fertility in women with early stage hormone receptor-negative breast cancer. Women who received goserelin in the study were 64% less likely to develop premature ovarian failure compared with women who received chemotherapy alone. They also were more likely to achieve successful pregnancies. Goserelin also was found to improve survival: the women in this arm were 50% more likely to be alive 4 years after the initiating of chemotherapy compared with those in the standard treatment arm. Lead author Halle Moore, MD, a staﬀ physician at the Cleveland Clinic, says that goserelin appears to be highly safe and eﬀective. The drug and similar luteinizing hormone-releasing hormone analogs temporarily shut down ovarian function, which is speculated to protect follicles from chemotherapy damage. These drugs are widely used to control ovulation timing for infertility procedures and as hormonal therapies to treat patients with advanced prostate and breast cancer. In the study, 257 premenopausal women with stage I to IIIA hormone receptor-negative breast cancer were randomized to either treatment with cyclophosphamide-containing chemotherapy alone or chemotherapy plus goserelin, which was given as monthly injections beginning 1 week prior to the ﬁrst dose of chemotherapy. Two years after starting chemotherapy, 8% of women in the goserelin treatment arm had ovarian failure compared with 22% of those receiving standard treatment. Approximately 21% of women assigned to receive goserelin plus chemotherapy became pregnant compared with 11% in the chemotherapy-alone arm. Approximately 15% of women in the goserelin treatment arm delivered at least 1 child, compared with 7% in the control arm. The study also found that goserelin was not associated with an increased risk of either pregnancy termination or miscarriage. Researchers further found that the drug aﬀected both disease-free and overall survival. After adjusting for disease
An NCI-led, phase 3 study indicates that adding the chemotherapy drug docetaxel to standard hormonal therapy extends survival for men with newly diagnosed, hormone-sensitive prostate cancer by approximately 10 months. In the subset of men with extensive disease spreads (high-extent disease), the survival beneﬁt was found to be even greater. Lead author Christopher Sweeney, MBBS, medical oncologist at the Lank Center for Genitourinary Oncology at the Dana-Farber Cancer Institute in Boston, Massachusetts, says that the beneﬁt warrants a new standard treatment for men who have high-extent disease and are ﬁt for chemotherapy. Hormonal therapy, also called androgen deprivation therapy (ADT), is the standard ﬁrst-line treatment of patients with hormonesensitive prostate cancer; however, the disease eventually becomes resistant to ADT in the majority of patients. The study involved 790 men with newly diagnosed prostate cancer who were randomly assigned to receive either ADT alone or ADT with docetaxel over a period of 18 weeks. Approximately two-thirds of the patients had highextent disease. The group threated with ADT plus docetaxel included 45 patients who received treatment when the disease worsened. The ADT-only group included 123 patients. At a median follow-up of 29 months, 136 patients in the ADT-alone group died versus 101 in the group threated with ADT plus docetaxel. That translated to a median overall survival of 44 months in the ADT-alone group and 57.6 months in the patients treated with ADT plus docetaxel. In median overall survival for the 520 patients with high extent-disease, the survival was 32.2 months in the ADT-alone group versus 492 months in the ADT plus docetaxel group. The median time to clinical disease progression was 19.8 months in the ADT group versus 33.7 months in the ADT-plus-docetaxel group. Dr. Sweeney adds that this new treatment paradigm will require earlier multidisciplinary care and collaboration between urologists and oncologists. Researchers plan to continue assessing survival beneﬁts for patients with low-extent disease as well as quality-of-life data. © LIGHTSPRING | SHUTTERSTOCK.COM
DOI: 10.1002/cncr.29068 Content in this section does not reﬂect any ofﬁcial policy or medical opinion of the American Cancer Society or of the publisher unless otherwise noted. © American Cancer Society, 2014.
October 15, 2014