Multidrug chemotherapy in the treatment of non-elderly patients with hormone-refractory prostatic carcinoma. A phase II study. North-Eastern Italian Oncology Group (GOCCNE).
OBJECTIVE
The effectiveness of a chemotherapy regimen including cisplatin, epirubicin, and estramustine phosphate was evaluated in a series of young patients with prostate cancer.


METHODS
28 patients with a histological diagnosis of prostatic carcinoma, age < 70 years, performance status (PS) < 2, hormone-refractory status, life expectancy > 3 months, were treated with cisplatin 60 mg/m2 i.v. and epirubicin 60 mg/m2 i.v. every 3 weeks for six cycles. Estramustine phosphate was administered at a dosage of 10 mg/kg p.o. in two divided daily doses during intravenous chemotherapy and until progression thereafter. The response was assessed after three cycles of chemotherapy, evaluating again the disease parameters. In case of partial remission or stable disease, treatment was continued for three additional cycles. The median age was 61.5 years, the median PS was 70.


RESULTS
11 partial remissions, 13 patients with stable disease, and 4 progressions were noted. The response rate (only partial remissions) was 39% (95% confidence limits 21-57%). The median duration of the partial remissions) was 11 (range 6-25) months. A subjective improvement of symptoms was observed in 17 of 19 patients. Toxicity was acceptable with no deaths. The median overall survival was 15 months.


CONCLUSIONS
The combination studied had activity in young prostate cancer patients, and our results suggest that this subset of patients needs specifically devised chemotherapy regimens.
Veronesi
A
A
Division of Preventive Oncology, Centro di Riferimento Oncologico, Aviano, Italy.
Re
G L
GL
Foladore
S
S
Merlo
A
A
Giuliotto
N
N
Talamini
R
R
Monfardini
S
S
D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage; D004334:Drug Administration Schedule; D015251:Epirubicin / Q000008:administration & dosage; D004961:Estramustine / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000401:mortality; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome
D000903:Antibiotics, Antineoplastic; D018931:Antineoplastic Agents, Hormonal; D004961:Estramustine; D015251:Epirubicin; D002945:Cisplatin