Loading
Giving the hormone-pathway drug abiraterone from the start, alongside standard testosterone suppression, cut deaths by more than a third in men newly diagnosed with high-risk or metastatic prostate cancer.
STAMPEDE is a multi-arm, multi-stage platform trial. This comparison randomised 1,917 men with newly diagnosed locally advanced or metastatic prostate cancer starting androgen deprivation therapy (ADT) to ADT alone or ADT plus abiraterone and prednisolone. Primary endpoint was overall survival.
Overall survival HR was 0.63 (3-year OS 83% vs 76%) and failure-free survival HR 0.29. Alongside LATITUDE, published the same day, it made early intensification of hormone therapy the standard for metastatic hormone-sensitive prostate cancer, and later STAMPEDE analyses extended this to high-risk non-metastatic disease. The platform design itself, testing many questions against one shared control arm, became a model for trial efficiency.
Men diagnosed with prostate cancer that has already spread, or that is locally advanced and high risk, should start abiraterone (or another androgen-receptor pathway inhibitor) at the same time as testosterone suppression rather than waiting for resistance. This roughly halves the risk of death over several years. The same platform later showed that docetaxel chemotherapy and, in high-volume metastatic disease, triple therapy also help, and that abiraterone benefits men with high-risk disease treated with radiotherapy.
Shares Mahesh K. B. Parmar, Silke Gillessen, Nicholas James, The Institute of Cancer Research.
Shares Nicholas James, Johann de Bono, The Institute of Cancer Research, The Royal Marsden.
Shares Basket, umbrella, and platform trials, No incentive to repurpose cheap drugs, Overall survival (OS), Cancer Research UK.
Shares Johann de Bono, The Institute of Cancer Research, The Royal Marsden, Localised prostate cancer, high and very high risk.
Shares STOpCaP: docetaxel or bisphosphonates added to standard of care in hormone-sensitive prostate cancer, a systematic review and meta-analysis, Metastatic hormone-sensitive prostate cancer, Prostate cancer roadmap: from Huggins and the discovery that a cancer can depend on a hormone, through the PSA epidemic and what it cost, the androgen receptor drugs, the DNA repair subset and PSMA, to a 2032 registry watch, New England Journal of Medicine.
Shares Johann de Bono, The Institute of Cancer Research, The Royal Marsden, Prostate cancer roadmap: from Huggins and the discovery that a cancer can depend on a hormone, through the PSA epidemic and what it cost, the androgen receptor drugs, the DNA repair subset and PSMA, to a 2032 registry watch.
Shares Johann de Bono, The Institute of Cancer Research, The Royal Marsden, Prostate cancer roadmap: from Huggins and the discovery that a cancer can depend on a hormone, through the PSA epidemic and what it cost, the androgen receptor drugs, the DNA repair subset and PSMA, to a 2032 registry watch.
Shares STOpCaP: docetaxel or bisphosphonates added to standard of care in hormone-sensitive prostate cancer, a systematic review and meta-analysis, Metastatic hormone-sensitive prostate cancer, Prostate cancer roadmap: from Huggins and the discovery that a cancer can depend on a hormone, through the PSA epidemic and what it cost, the androgen receptor drugs, the DNA repair subset and PSMA, to a 2032 registry watch, Trial design, endpoints and cost.