Docetaxel plus prednisone versus mitoxantrone plus prednisone for metastatic hormone-refractory prostate cancer in Chinese patients: experience of a single center.
OBJECTIVE
To preliminarily investigate the efficacy of docetaxel plus prednisone and mitoxantrone plus prednisone for treating metastatic hormone-refractory prostate cancer and to further evaluate its adverse events in Chinese patients.


METHODS
83 patients with metastatic hormone-refractory prostate cancer were enrolled in the trial and given a combination of docetaxel 75 mg/m(2) intravenously on day 2 or mitoxantrone 12 mg/m(2) on day 1 plus prednisone 5 mg twice daily on days 1-21, 21 days a cycle. Serum PSA level, relief of bone pain, myelosuppression, and vomiting were recorded and calculated.


RESULTS
Docetaxel plus prednisone was administered to 44 patients: 13.6% (6/44) of them achieved complete response, 29.5% (13/44) partial response, 29.5% (13/44) had stable disease, and 27.3% (12/44) had disease progression. The average time to PSA progression was 37.8 weeks (12-101 weeks) in the response and stable disease patients. The 12 patients with disease progression were given MP as salvage therapy, and 16.7% (2/12) achieved a partial response, 25.0% (3/12) had stable disease and formed the new baseline. Only 2 patients died of disease aggravation. Mitoxantrone plus prednisone were given to 39 patients, and 7.7% (3/39) of them achieved complete response, 25.6% (10/39) partial response, 25.6% (10/39) had a stable disease, and 41.0% (16/39) of patients had disease progression. The mean time to PSA progression was 25.3 weeks (8-61 weeks) in the response and stable disease patients. The 14 patients with disease progression were administered DP as a salvage therapy and 7.1% (1/14) achieved complete response, 35.7% (5/14) partial response, and 21.4% (3/14) had stable disease and formed the new baseline. Four patients had died at the last follow-up.


CONCLUSIONS
In Chinese patients, docetaxel plus prednisone is better than mitoxantrone plus prednisone in PSA response rate and PSA control, but has a bit more toxicity. When the tumor is resistant to one regimen, the other might still be effective in controlling disease progression.
Zhang
Hai Liang
HL
Department of Urology, Cancer Hospital, Fudan University, Shanghai, PR China.
Ye
Ding Wei
DW
Yao
Xu Dong
XD
Dai
Bo
B
Zhang
Shi Lin
SL
Shen
Yi Jun
YJ
Zhu
Yao
Y
Zhang
Wen
W
D000230:Adenocarcinoma / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D000368:Aged; D000369:Aged, 80 and over; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000009:adverse effects; D001707:Biopsy, Needle; D017024:Chemotherapy, Adjuvant; D002681:China; D000077143:Docetaxel; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005500:Follow-Up Studies; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D020714:Maximum Tolerated Dose; D008875:Middle Aged; D008942:Mitoxantrone / Q000008:administration & dosage / Q000009:adverse effects; D009367:Neoplasm Staging; D011241:Prednisone / Q000008:administration & dosage / Q000009:adverse effects; D011336:Probability; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D018570:Risk Assessment; D015996:Survival Rate; D043823:Taxoids / Q000008:administration & dosage / Q000009:adverse effects; D017211:Treatment Failure; D016896:Treatment Outcome
D018931:Antineoplastic Agents, Hormonal; D043823:Taxoids; D000077143:Docetaxel; D008942:Mitoxantrone; D017430:Prostate-Specific Antigen; D011241:Prednisone