title: Phase II study of sequential chemotherapy with docetaxel-estramustine followed by mitoxantrone-prednisone in patients with advanced hormone-refractory prostate cancer.
abstract: Sequential chemotherapy may improve treatment efficacy avoiding the additive toxicity associated with concomitant polichemotherapy in hormone-refractory prostate cancer (HRPC). Forty patients received docetaxel 30 mg m(-2) intravenous (i.v.), weekly, plus estramustine 280 mg twice daily for 12 weeks. After 2 weeks rest, patients with a decline or stable PSA were treated with mitoxantrone 12 mg m(-2) i.v. every 3 weeks plus prednisone 5 mg twice daily for 12 cycles. Forty patients were assessable for toxicity after docetaxel/estramustine. Main toxicities were grade 3-4 AST/ALT or bilirubin increase in seven patients (17.5%) and deep venous thrombosis (DVT) in four patients (10%). Twenty-seven patients received mitoxantrone/prednisone. Main toxicities included DVT in one patient (3.7%) and congestive heart failure in two patients (7%). Thirty-nine patients were assessable for PSA response. Twenty-nine patients (72.5%; 95% CI 63-82%) obtained a >/=50% PSA decline with 15 patients (37.5%; 95% CI 20-50%) that demonstrated a >/=90% decrease. Median progression-free and overall survival were respectively 7.0 (95% CI 5.8-8.2 months) and 19.2 months (95% CI 13.9-24.3 months). In conclusion, although this regimen demonstrated a favourable toxicity profile, sequential administration of mitoxantrone is not able to improve docetaxel activity in patients with HRPC.
authors.affiliation: Division of Medical Oncology, Azienda USL 6 of Livorno, Livorno 57100, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Galli
authors.forename: A
authors.initials: A
authors.lastname: Fontana
authors.forename: C
authors.initials: C
authors.lastname: Galli
authors.forename: L
authors.initials: L
authors.lastname: Landi
authors.forename: E
authors.initials: E
authors.lastname: Fontana
authors.forename: A
authors.initials: A
authors.lastname: Antonuzzo
authors.forename: M
authors.initials: M
authors.lastname: Andreuccetti
authors.forename: E
authors.initials: E
authors.lastname: Aitini
authors.forename: R
authors.initials: R
authors.lastname: Barbieri
authors.forename: R
authors.initials: R
authors.lastname: Di Marsico
authors.forename: A
authors.initials: A
authors.lastname: Falcone
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018931:Antineoplastic Agents, Hormonal / Q000494:pharmacology; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D018572:Disease-Free Survival; D000077143:Docetaxel; D004334:Drug Administration Schedule; D019008:Drug Resistance, Neoplasm; D004961:Estramustine / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008942:Mitoxantrone / Q000008:administration & dosage*; D011241:Prednisone / Q000008:administration & dosage*; D011471:Prostatic Neoplasms / Q000188:drug therapy*; D015996:Survival Rate; D043823:Taxoids / Q000008:administration & dosage*
chemical_list: D018931:Antineoplastic Agents, Hormonal; D043823:Taxoids; D000077143:Docetaxel; D004961:Estramustine; D008942:Mitoxantrone; D011241:Prednisone