Combining 153Sm-lexidronam and docetaxel for the treatment of patients with hormone-refractory prostate cancer: first experience.
OBJECTIVE
153Sm-lexidronam has been used for the palliation of symptoms from painful bone metastases for years, while docetaxel has recently been shown to improve the survival of patients with hormone-refractory prostate cancer (HRPC). The first clinical experience with the combination of both treatment modalities is reported.


METHODS
Between 2005 and 2006, 12 patients with muliple bone metastases from HRPC were treated with a single application of 37 MBq/kg body weight 153Sm-lexidronam and 6 weekly infusions of 35 mg/m2 docetaxel. Data on survival, prostate-specific antigen (PSA) response, symptom palliation, toxicity, and scintigraphic follow-up are provided.


RESULTS
Mean follow-up was 11.4 (range, 1.1-25.8) months, overall 1-year survival was 48.6%, and median survival was 11.5 months. A PSA response of >50% was documented in 50% of patients. The average pain score (visual analog scale: 1-10) was reduced from 5.1 to 1.4 (p = 0.016) with decrease of > or =2 in 58.3% of patients. The average World Health Organization medication level dropped from 1.6 to 1.1 (p = 0.5). Overall toxicity was moderate, but 1 patient died due to neutropenic sepsis.


CONCLUSIONS
Our analysis demonstrates feasibility and therapeutic potential for the combination treatment and merits prospective investigation. Further studies will be planned with respect to the potentially synergistic hematologic toxicity of bone-seeking radiopharmaceuticals and chemotherapy.
Suttmann
Henrik
H
Department of Urology and Pediatric Urology , Saarland University Medical Center, Homburg/Saar, Germany.
Grgic
Aleksandar
A
Lehmann
Jan
J
Zwergel
Ulrike
U
Kamradt
Jörn
J
Gouverneur
Eric
E
Pinkert
Jörg
J
Stöckle
Michael
M
Kirsch
Carl-Martin
CM
Nestle
Ursula
U
D000368:Aged; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage; D000970:Antineoplastic Agents / Q000008:administration & dosage; D001835:Body Weight; D000077143:Docetaxel; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009942:Organometallic Compounds / Q000008:administration & dosage*; D009943:Organophosphorus Compounds / Q000008:administration & dosage*; D017430:Prostate-Specific Antigen / Q000096:biosynthesis; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy*; D011868:Radioisotopes / Q000008:administration & dosage; D043823:Taxoids / Q000008:administration & dosage*; D013997:Time Factors; D016896:Treatment Outcome
D018712:Analgesics, Non-Narcotic; D000970:Antineoplastic Agents; D009942:Organometallic Compounds; D009943:Organophosphorus Compounds; D011868:Radioisotopes; D043823:Taxoids; D000077143:Docetaxel; C061972:samarium Sm-153 lexidronam; D017430:Prostate-Specific Antigen