Multi-Drug Combo May Be Best Against Prostate Cancer

January 25, 2024
Dennis Thompson HealthDay Reporter

Combining two or three testosterone-blocking drugs prevents the spread of prostate cancer better than just a single medication, a new clinical trial has found.

Men who received two or three hormone blockers remained cancer-free with lower PSA levels for longer than those only receiving one drug, researchers found.

Once off the treatment, men who took the combo therapy saw testosterone levels recover just as quickly as those who took a single drug.

"This adds to a growing body of evidence in favor of more intensive testosterone-blocking therapy in patients with higher-risk prostate cancer,"said lead researcher Dr. Rahul Aggarwal, an oncologist and professor with the University of California, San Francisco's School of Medicine.

Prostate cancer affects about one in every eight men, and causes 34,000 deaths in the United States each year, researchers said in background notes.

For the study, the team focused on men who had suffered a relapse following prostate cancer surgery. The relapse was detected through a sudden increase in blood levels of PSA (prostate-specific antigen).

"We looked at patients who had a fast rise in their PSA -- an indicator of a higher-risk form of relapsed prostate cancer,"Aggarwal said. "Our goal was to test several different hormone therapy strategies to find the best approach in terms of delaying the cancer's progression."

Researchers recruited more than 500 of these patients between 2017 and 2022 to take either a single testosterone-blocking drug or a combination of two or three blockers. The patients stayed on their assigned therapy for a year.

All of the patients experienced a dramatic plunge in their testosterone levels, which put the brakes on their cancer but also caused fatigue, hot flashes, decreased libido and other side effects.

However, patients taking the combo-drug regimen had better PSA levels, remained cancer-free longer and recovered as quickly once off the hormone blockers, results show.

The new study was published Jan. 23 in the Journal of Clinical Oncology.

Researchers are following up with a more detailed analysis of how patients fared on the different combinations.

"New cancer therapies must clear a high bar to make their way to patients,"Aggarwal said. "With the evidence in this study and others, combination hormone therapy should be considered a standard of care in prostate cancer patients with high-risk relapse after prior treatment."

More information

The American Cancer Society has more about prostate cancer treatment.

SOURCE: University of California, San Francisco, news release, Jan. 23, 2024

Cancer: Prostate