title: Docetaxel, bevacizumab, and androgen deprivation therapy for biochemical disease recurrence after definitive local therapy for prostate cancer.
abstract: BACKGROUND
  Patients with biochemical disease recurrence (BCR) after definitive treatment for prostate cancer comprise a heterogeneous population for whom standard therapy options are lacking. The purpose of the current trial was to evaluate the feasibility, toxicity, and efficacy of early multimodality systemic therapy in men with BCR.
  
  
  METHODS
  Eligible patients had an increasing prostate-specific antigen (PSA) level, a PSA doubling time ≤10 months, and no evidence of metastases after radical prostatectomy (RP) and/or radiotherapy (RT) for localized disease. Treatment consisted of docetaxel at a dose of 75 mg/m(2) every 3 weeks for 4 cycles, bevacizumab at a dose of 15 mg/kg every 3 weeks for 8 cycles, and androgen deprivation therapy (ADT) for 18 months. The primary endpoint was the percentage of patients who were free from PSA progression 1 year after the completion of therapy.
  
  
  RESULTS
  A total of 41 patients were included in the analysis. At 1 year after the completion of ADT, 45% of patients (13 of 29 patients) and 29% of patients (5 of 17 patients) with a testosterone level ≥100 ng/dL and ≥240 ng/dL, respectively, had a PSA <0.2 ng/mL. The median follow-up was 27.5 months (interquartile range, 21.8-38.1 months). Eight patients (20%) were free from PSA progression, 19 patients (46%) did not reinitiate ADT, and 34 patients (83%) were free from metastasis. Sixteen patients (39%) experienced grade 3 and 5 patients (12%) experienced grade 4 toxicities (toxicity was assessed using the National Cancer Institute Common Terminology Criteria for Adverse Events [version 3.0]).
  
  
  CONCLUSIONS
  Multimodality systemic therapy with docetaxel, bevacizumab, and ADT is feasible and produces PSA responses in men with BCR. Long-term follow-up is needed to determine the percentage of patients with a durable PSA response who are able to avoid having to reinitiate prostate cancer therapy.
authors.affiliation: Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.
authors.forename: Rana R
authors.initials: RR
authors.lastname: McKay
authors.affiliation: Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.
authors.forename: Kathryn P
authors.initials: KP
authors.lastname: Gray
authors.affiliation: Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.
authors.forename: Julia H
authors.initials: JH
authors.lastname: Hayes
authors.affiliation: Genitourinary Medical Oncology, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
authors.forename: Glenn J
authors.initials: GJ
authors.lastname: Bubley
authors.affiliation: Genitourinary Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York.
authors.forename: Jonathan E
authors.initials: JE
authors.lastname: Rosenberg
authors.affiliation: Medical Oncology/Hematology Program, Greenebaum Cancer Center, Baltimore, Maryland.
authors.forename: Arif
authors.initials: A
authors.lastname: Hussain
authors.affiliation: Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.
authors.forename: Philip W
authors.initials: PW
authors.lastname: Kantoff
authors.affiliation: Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.
authors.forename: Mary-Ellen
authors.initials: ME
authors.lastname: Taplin
mesh_terms: D000230:Adenocarcinoma / Q000097:blood / Q000188:drug therapy* / Q000473:pathology; D000726:Androgen Antagonists / Q000008:administration & dosage* / Q000009:adverse effects; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage* / Q000009:adverse effects; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage / Q000009:adverse effects; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D000068258:Bevacizumab; D014408:Biomarkers, Tumor / Q000097:blood; D017024:Chemotherapy, Adjuvant; D000077143:Docetaxel; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy*; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000473:pathology; D043823:Taxoids / Q000008:administration & dosage* / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D000726:Androgen Antagonists; D061067:Antibodies, Monoclonal, Humanized; D018931:Antineoplastic Agents, Hormonal; D014408:Biomarkers, Tumor; D043823:Taxoids; D000077143:Docetaxel; D000068258:Bevacizumab; D017430:Prostate-Specific Antigen
keywords: androgen deprivation therapy; bevacizumab; biochemical disease recurrence; docetaxel; prostate cancer