Estramustine and vinblastine: use of prostate specific antigen as a clinical trial end point for hormone refractory prostatic cancer.
The combination of estramustine phosphate and vinblastine sulfate, 2 agents with separate and unique antimicrotubular effects, has demonstrated additive cytotoxicity against the DU145 human prostate derived cell line in vitro. We evaluated this combination in 25 patients with progressive hormone refractory prostate cancer. Of 24 patients with an elevated prostate specific antigen (PSA) level at the start of treatment 13 (54%, 95% confidence limits 34 to 74%) had a greater than 50% decrease in PSA levels on at least 3 consecutive biweekly determinations. The median decrease in PSA in responding patients was 64% (mean 71.7%) and the median duration of response was 7 months. In 5 patients with bidimensionally measurable disease 2 partial responses were observed. Treatment was well tolerated, with mild and manageable toxicity. This is a well tolerated outpatient treatment regimen for patients with hormone-refractory prostatic cancer which deserves further investigation.
Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York 10021.
A D
AD
Seidman
H I
HI
Scher
D
D
Petrylak
D D
DD
Dershaw
T
T
Curley
D000368:Aged; D000369:Aged, 80 and over; D000951:Antigens, Neoplasm / Q000097:blood*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000097:blood*; D004054:Diethylstilbestrol / Q000627:therapeutic use; D004961:Estramustine / Q000008:administration & dosage; D005485:Flutamide / Q000627:therapeutic use; D007987:Gonadotropin-Releasing Hormone / Q000031:analogs & derivatives / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008535:Megestrol / Q000031:analogs & derivatives / Q000627:therapeutic use; D019290:Megestrol Acetate; D008875:Middle Aged; D009919:Orchiectomy; D017430:Prostate-Specific Antigen; D011471:Prostatic Neoplasms / Q000097:blood / Q000188:drug therapy*; D014747:Vinblastine / Q000008:administration & dosage
D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D007987:Gonadotropin-Releasing Hormone; D004961:Estramustine; D014747:Vinblastine; D004054:Diethylstilbestrol; D005485:Flutamide; D008535:Megestrol; D017430:Prostate-Specific Antigen; D019290:Megestrol Acetate