Hormone patches effectively control advanced prostate cancer, study finds

Hormone patches are just as effective as injections at delivering hormone therapy and treating locally advanced prostate cancer, a new study finds.

The study, which was published in The New England Journal of Medicine and conducted by researchers at University College London, found that patches that lower testosterone by delivering oestradiol – a form of oestrogen – through the skin were as effective as injections at preventing the cancer from spreading, and caused fewer side effects.

Simon Grieveson, assistant director of research at Prostate Cancer UK, said: ‘Hormone therapy is an extremely common and effective treatment for prostate cancer, currently given through regular injections. But for many men it can cause quite significant side effects.’

‘Results from [this study have] shown that hormone patches like these, delivered through the skin, are just as effective at delaying cancer progression. The skin patches also resulted in fewer men experiencing hot flushes; however, breast tissue swelling was more common.’

‘These skin patches are more convenient and less invasive and could give men greater choice in their treatment based on what's important to them and how they live their lives.’

This phase 3 randomised trial ran across 75 centres in the UK between 2007 and 2022 and recruited 1,360 patients with locally advanced, non-metastatic prostate cancer.

Participants were randomised to receive either transdermal oestradiol patches or standard injectable hormone therapy of LHRH agonists (luteinising hormone-releasing hormone agonists).

The study found that oestradiol patches were non-inferior to standard hormone injections – meaning they performed at least as well. After three years, 87% of patients in the oestradiol patch group were alive with no sign of their cancer spreading, compared with 86% in the LHRH injection group.

The team also compared the side effects of the two approaches. Side effects from LHRH agonists come not only from lower levels of testosterone but also from lower oestrogen levels. That is because most oestrogen in men is converted from testosterone.

Oestradiol patches add oestrogen to the body, which causes less testosterone production, so side effects related to low oestrogen levels – such as hot flushes – are greatly reduced.

Among those using patches, only 44% reported any hot flushes compared to 89% in the injection group. However, breast tissue swelling – called gynaecomastia – was more frequent with patches, affecting 85% of participants compared to 42% of those on injections.

The researchers also found that fewer patients in the patch group experienced bone fractures within five years — 2.8% compared with 5.8% in the injection group.

Previous studies comparing oestradiol patches to LHRH agonists have shown that overall quality of life scores are better in men receiving the patches compared to the injections.

Professor Ruth Langley, the lead author of the study, said: ‘We believe our findings should lead to men with locally advanced prostate cancer being able to choose which hormone therapy suits them best. For some men, for instance, hot flushes can be very debilitating, and so the patches could greatly increase their quality of life.’

According to Cancer Research UK, one in six males in the UK will be diagnosed with prostate cancer in their lifetime. Moreover, they state that there are around 55,300 new prostate cancer cases every year.

Caroline Geraghty, senior specialist nurse manager at Cancer Research UK, said: ‘Prostate cancer remains the most common cancer in men in the UK – that’s why we must continue to find new breakthroughs in treating the disease.’

‘Thanks to research, over 8 in 10 men diagnosed with prostate cancer will now survive for 10 years or more. As well as finding more effective treatments, we need to find ways to make them kinder too.’

‘This trial has done exactly that – it shows that hormone patches are just as effective as traditional injections at controlling locally advanced prostate cancer, while being much easier and gentler to administer.’

‘This should give men greater choice over their treatment in the future, allowing them to live not just longer lives, but better lives.’