A modified low-dose regimen of mitoxantrone and prednisolone in patients with androgen-independent prostate cancer.
BACKGROUND
We conducted this retrospective study to analyze a modified dose schedule of mitoxantrone and prednisolone (MP) in patients with androgen-independent prostate cancer.


METHODS
From June 1997 to April 2002, 28 patients were enrolled. Their median age was 69 years (range, 58-79 years). The median duration of hormonal therapy was 30 months (range, 6-84 months). The median performance status was 2. Sixteen of the patients had bone disease only. The chemotherapy consisted of 8 mg/m2 mitoxantrone by intravenous infusion every 3 weeks and 10 mg prednisolone orally twice per day. WHO response criteria, prostatic-specific antigen (PSA), pain and performance status were used to assess the response.


RESULTS
The median number of treatment cycles was six (range, 2-20). Nine (32.1%) and 15 patients (53.8%) had > or =80% and > or =50% reduction in serum PSA level, respectively. Of 16 patients using narcotics, five (31.3%) had a > or =50% reduction in narcotics consumption compared with the baseline. Nine patients (32.1%) showed improved performance. For 12 patients with measurable disease, only two (16.7%) showed a partial response. Grade 3-4 toxicities included neutropenia (three patients), anemia (three patients) and vomiting (one patient). The median survival was 12 months and the median time to PSA progression was 4 months.


CONCLUSIONS
This modified regimen is feasible for palliative intent. The toxicity of this regimen is manageable. Exploring further combinations of this regimen with novel agents against androgen-independent prostate cancer is warranted.
Sheen
Wen-Chyi
WC
Division of Hematology/Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, 199 Tun-Hwa North Road, Taipei, Taiwan.
Chen
Jen-Shi
JS
Wang
Hung-Ming
HM
Yang
Tsai-Shen
TS
Liaw
Chuang-Chi
CC
Lin
Yung-Chang
YC
D000368:Aged; D000740:Anemia / Q000139:chemically induced; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D018450:Disease Progression; D004334:Drug Administration Schedule; D006801:Humans; D008297:Male; D008875:Middle Aged; D008942:Mitoxantrone / Q000008:administration & dosage / Q000009:adverse effects; D009503:Neutropenia / Q000139:chemically induced; D011239:Prednisolone / Q000008:administration & dosage* / Q000009:adverse effects; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000188:drug therapy*; D012189:Retrospective Studies; D015996:Survival Rate
D011239:Prednisolone; D008942:Mitoxantrone; D017430:Prostate-Specific Antigen