title: Metronomic treatment with low-dose trofosfamide leads to a long-term remission in a patient with docetaxel-refractory advanced metastatic prostate cancer.
abstract: The treatment of metastatic prostate cancer patients refractory to androgen withdrawal and docetaxel therapy is currently discouraging and new therapeutic approaches are vastly needed. Here, we report a long-term remission over one year in a 68-year-old patient with metastatic docetaxel-refractory prostate cancer employing low-dose trofosfamide. The patient suffered from distant failure with several bone lesions and lymph node metastases depicted by a (11) C-Choline positron emission tomography/computerized tomography (PET/CT). After initiation of trofosfamide 100 mg taken orally once a day we observed a steadily decreasing PSA value from initial 46.6 down to 2.1 mug/L. The Choline-PET/CT was repeated after 10 months of continuous therapy and demonstrated a partial remission of the bone lesions and a regression of all involved lymph nodes but one. Taken together we found an astonishing and durable activity of the alkylating agent trofosfamide given in a metronomic fashion. We rate the side effects as low and state an excellent therapeutic ratio of this drug in our patient.
authors.affiliation: Department of Internal Medicine III, University of Ulm, Albert Einstein-Allee 23, 89081 Ulm, Germany.
authors.forename: Jochen
authors.initials: J
authors.lastname: Greiner
authors.forename: Rainer
authors.initials: R
authors.lastname: Küfer
authors.forename: Sven N
authors.initials: SN
authors.lastname: Reske
authors.forename: Volker
authors.initials: V
authors.lastname: Martin
authors.forename: Hartmut
authors.initials: H
authors.lastname: Döhner
authors.forename: Mark
authors.initials: M
authors.lastname: Ringhoffer
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