title: Chemotherapy for hormonally refractory advanced prostate carcinoma. A comparison of combined versus sequential treatment with mitomycin C, doxorubicin, and 5-fluorouracil.
abstract: One hundred forty-two patients with progressive, hormonally refractory advanced prostate carcinoma who had not received prior chemotherapy were randomized to receive either combination chemotherapy with 5-fluorouracil (5-FU), doxorubicin, and mitomycin C (FAM) or sequential chemotherapy with the same agents, i.e., mitomycin C, followed by doxorubicin on disease progression, followed by 5-FU. Objective tumor regressions were observed in 10 of 70 (14%) patients receiving the FAM treatment arm and 10 of 72 (14%) patients initially receiving mitomycin C. Of the 24 patients who received secondary therapy with doxorubicin alone, 3 (12.5%) achieved objective tumor regression. There were no responses among five patients who received tertiary therapy with 5-FU alone. The median survival time for all patients treated with the combination arm was 8.7 months, compared with 7.1 months for patients who received the FAM arm (P = 0.025). However, this modest survival advantage in favor of the FAM treatment arm must be weighed against significantly more myelosuppression experienced by these patients. The chemotherapeutic regimens used in this study have only minor clinical value in the treatment of hormonally refractory advanced prostate cancer.
authors.affiliation: Grand Forks Clinic, Ltd., Grand Forks, North Dakota.
authors.forename: J A
authors.initials: JA
authors.lastname: Laurie
authors.forename: R G
authors.initials: RG
authors.lastname: Hahn
authors.forename: T M
authors.initials: TM
authors.lastname: Therneau
authors.forename: S R
authors.initials: SR
authors.lastname: Patel
authors.forename: J A
authors.initials: JA
authors.lastname: Mailliard
authors.forename: H E
authors.initials: HE
authors.lastname: Windschitl
authors.forename: D I
authors.initials: DI
authors.lastname: Twito
authors.forename: R F
authors.initials: RF
authors.lastname: Morton
authors.forename: J E
authors.initials: JE
authors.lastname: Krook
mesh_terms: D000135:Acid Phosphatase / Q000032:analysis; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002277:Carcinoma / Q000188:drug therapy* / Q000201:enzymology / Q000473:pathology; D004317:Doxorubicin / Q000008:administration & dosage* / Q000009:adverse effects; D005472:Fluorouracil / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D007970:Leukopenia / Q000139:chemically induced; D008297:Male; D016685:Mitomycin / Q000008:administration & dosage* / Q000009:adverse effects; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000201:enzymology / Q000473:pathology; D012074:Remission Induction; D015996:Survival Rate; D013921:Thrombocytopenia / Q000139:chemically induced
chemical_list: D016685:Mitomycin; D004317:Doxorubicin; D000135:Acid Phosphatase; D005472:Fluorouracil