title: Response to vinorelbine with or without estramustine as second-line chemotherapy in patients with hormone-refractory prostate cancer.
abstract: BACKGROUND
  Vinorelbine (VRL) in combination with estramustine has known efficacy in the initial chemotherapeutic management of hormone-refractory prostate cancer (HRPC). However, little is known about the efficacy of VRL as second-line chemotherapy in HRPC.
  
  
  METHODS
  We retrospectively identified patients with HRPC treated in a single institution with VRL as second-line chemotherapy with or without estramustine. Patient baseline characteristics, declines in prostate-specific antigen, performance status, toxicities, and survival were assessed.
  
  
  RESULTS
  Thirty-nine patients were treated with VRL between 1999 and 2005. Twenty-one patients (54%) received single-agent VRL and 18 patients (46%) had concomitant estramustine. Seven patients (17.9%, 95% confidence interval 7.5%-33.6%) treated with VRL experienced prostate-specific antigen declines >or=50%. Median duration of therapy was 1.4 months (range 0.2-14.0 months). Median overall survival was 6.9 months (range 1.4-29.9 months); it was 16.1 month in responders and 5.5 months in nonresponders. Median survival was significantly longer in patients with VRL and estramustine than in patients who received VRL alone (8.5 months versus 4.1 months, P=0.05). The most common reversible adverse effect of VRL was grade 1 or 2 fatigue observed in 36% of patients.
  
  
  CONCLUSIONS
  As a second-line chemotherapy, VRL demonstrated moderate activity and was well tolerated in patients with HRPC. Patients treated with the combination of VRL and estramustine experienced a longer survival than those receiving VRL alone.
authors.affiliation: Lank Center for Genitourinary Oncology, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02115, USA.
authors.forename: Mari
authors.initials: M
authors.lastname: Nakabayashi
authors.forename: Jonathan
authors.initials: J
authors.lastname: Ling
authors.forename: Wanling
authors.initials: W
authors.lastname: Xie
authors.forename: Meredith M
authors.initials: MM
authors.lastname: Regan
authors.forename: William K
authors.initials: WK
authors.lastname: Oh
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D004961:Estramustine / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008942:Mitoxantrone / Q000627:therapeutic use; D009503:Neutropenia / Q000139:chemically induced; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000401:mortality*; D012189:Retrospective Studies; D043823:Taxoids / Q000627:therapeutic use; D013997:Time Factors; D016896:Treatment Outcome; D014747:Vinblastine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000077235:Vinorelbine
chemical_list: D000970:Antineoplastic Agents; D043823:Taxoids; D004961:Estramustine; D014747:Vinblastine; D008942:Mitoxantrone; D017430:Prostate-Specific Antigen; D000077235:Vinorelbine