Life Extension Magazine®

Pharmacists reading on fulvestrant and anastrozole

Research Outcomes on Cancer Drugs

Two drugs demonstrate benefits in treating prostate and breast cancers.

Scientifically reviewed by: Dr. Tennoy V., MD, in August 2023. Written by: Shirley Givens.

The New England Journal of Medicine published results from two clinical trials of drugs for treating prostate and breast cancer.1,2

The studies showed that both drugs have promise in prolonging survival.

But the gains being made are only baby steps. Despite improvements in care, cancer remains the second most common cause of death in the U.S. and worldwide, closely trailing cardiovascular disease.3

Need for Adjuvant Therapies

The study described in this article shows the additive benefits of combining two anti-estrogen drugs as follows:

Anastrozole
to block formation of estrogen

+

Fulvestrant
to degrade estrogen-receptor sites

=

Increased
Median Survival

While meaningful by conventional oncology standards, the fact that 71% of the fulvestrant plus anastrozole group died demonstrates that more needs to be done when battling metastatic breast cancer.

To review a comprehensive strategy that breast cancer patients may consider, log on to: LifeExtension.com/breast

Non-Metastatic Prostate Cancer in Men

Scientist working

Androgen-deprivation therapy is a prostate cancer treatment that reduces levels of androgens, the predominant sex hormones in men, which include testosterone.

This therapy is most commonly done with drugs that prevent testosterone from being produced in the body and/or blocking testosterone from binding to cellular receptor sites. Androgen-blocking therapy works for many prostate cancers because testosterone and other androgens stimulate the growth of some tumors.

Some prostate cancers do not respond adequately to this type of treatment and the disease continues to progress.

One of the recent cancer studies focused on men suffering from non-metastatic (localized) prostate cancer that doesn’t respond to androgen-deprivation therapy.1

Researchers studied men with this type of prostate cancer to evaluate whether the drug, darolutamide, could slow the progression of the disease. Darolutamide blocks receptors on cells that respond to testosterone.

More than 1,500 men with prostate cancer were randomized to receive darolutamide or a placebo.

Men receiving the drug (darolutamide) more than doubled the average metastasis-free survival time, from 18.4 months with the placebo to 40.4 months with darolutamide. Men receiving this drug also delayed the progression to pain.

Metastatic Breast Cancer in Women

Doctor working

The second clinical trial studied 694 postmenopausal women with hormone receptor-positive metastatic breast cancer.2

This type of cancer has already spread to distant tissues in the body, a sign of a poor prognosis.

Estrogen receptor-positive breast cancers are characterized by the presence of estrogen receptors in breast cancer cells. These estrogen receptors bind to the hormone estrogen that then fuels tumor cell growth.

In this study, subjects were randomized to receive either the widely used aromatase-inhibitor drug anastrozole or a combination of anastrozole with the drug fulvestrant.

Anastrozole blocks an enzyme (aromatase) involved in the formation of estrogen, reducing its levels.

Fulvestrant binds to breast cancer cell estrogen receptors, degrading them, which in turn inhibits processes involved with estrogen-fueled tumor growth.4 The hope was that the combination treatment (anastrozole plus fulvestrant) would have a synergistic effect, bolstering the effect of anastrozole alone.

Researchers analyzed the results of the study over a period of more than five years. The group who received anastrazole with fulvestrant had a median survival of 49.8 months, which was significantly higher than the 42-month median survival experienced by the group who received anastrazole alone.

The improvement in survival in the fulvestrant group is even more impressive given that the women received only half the dose of fulvestrant than is currently considered to be most effective.

That represents an incremental improvement in the duration of survival with the combination treatment.

Cancer Prevention: An Important Goal

In addition to pursuing more effective treatments, we need to focus on trying to prevent cancer in the first place.

Scientific research has shown that as many as 90% of all cancers are caused by environmental factors or lifestyle behaviors, and are therefore potentially preventable.5-7

Many actions can cut the risk of developing cancer, including:

  • Not smoking and avoiding secondhand smoke,
  • Limiting fried foods and red meat,
  • Moderating alcohol intake,
  • Increasing exercise,
  • Eating more fruits and vegetables,
  • Consuming nutrients that reduce inflammation and activate anti-cancer mechanisms.5

What you need to know

  • Cancer is the second-leading cause of death, after heart disease, in the U.S.
  • Two recently published studies showed that novel treatments for two types of cancer were improvements over existing treatment.
  • A new androgen-receptor blocker drug called darolutamide significantly extended the metastasis-free survival of men with prostate cancer, more than doubling the time to metastasis.
  • Addition of the drug fulvestrant, which blocks the action of estrogens in the tumor, to treatment with anastrozole in women with hormone receptor-positive metastatic breast cancer extended survival time a modest amount.
  • Despite these and other recent advances, cancer is still a deadly, and dreaded, disease that affects the lives of many millions of people.
  • Most cancers are potentially preventable, because modifiable factors such as lifestyle choices, diet, and exercise contribute significantly to reducing risk.
  • While medical science makes slow improvements in cancer treatment, people can take steps to reduce the risk for developing cancer in the first place, which is crucial to further reducing the burden of this devastating disease.

Summary

Image of cancer cell

Scientists continue to make slow progress in the search for better treatments for cancer.

Two recently published studies demonstrate that two drug treatments resulted in improved survival rates for prostate and breast cancer.

In one, the drug darolutamide for prostate cancer in men more than doubled the length of progression-free survival. In the other, women with metastatic breast cancer saw a modest reduction in mortality with a combination treatment with the drugs fulvestrant and anastrozole.

These improvements are promising but are a long way from a cure. Making lifestyle changes to prevent cancer is vital and even more important for those undergoing treatment or seeking a long-term complete response.

Reducing known causative factors (such as poor diet) slashes one’s risk of developing cancer.

If you have any questions on the scientific content of this article, please call a Life Extension® Wellness Specialist at 1-866-864-3027.

References

  1. Fizazi K, Shore N, Tammela TL, et al. Darolutamide in Nonmetastatic, Castration-Resistant Prostate Cancer. N Engl J Med. 2019 Mar 28;380(13):1235-46.
  2. Mehta RS, Barlow WE, Albain KS, et al. Overall Survival with Fulvestrant plus Anastrozole in Metastatic Breast Cancer. N Engl J Med. 2019 Mar 28;380(13):1226-34.
  3. Xu J, Murphy SL, Kochanek KD, et al. Center for Disease Control. Deaths: Final Data for 2016. National Vital Statistics Reports. 2018;67(5):1-75.
  4. Available at: https://www.cancer.gov/news-events/cancer-currents-blog/2017/fda-fulvestrant-breast-cancer. Accessed June 28, 2019.
  5. Anand P, Kunnumakkara AB, Sundaram C, et al. Cancer is a preventable disease that requires major lifestyle changes. Pharm Res. 2008 Sep;25(9):2097-116.
  6. Wu S, Powers S, Zhu W, et al. Substantial contribution of extrinsic risk factors to cancer development. Nature. 2016 Jan 7;529(7584):43-7.
  7. Wu S, Zhu W, Thompson P, et al. Evaluating intrinsic and non-intrinsic cancer risk factors. Nat Commun. 2018 Aug 28;9(1):3490.