COUMARIN (1,2-BENZOPYRONE) FOR THE TREATMENT OF PROSTATIC-CARCINOMA

The unavailablility of effective treatment for metastatic hormone-refr actory and clinically localized but pathologically unfavorable prostat ic carcinoma warrants trial of new and promising treatments. Prelimina ry studies in patients with metastatic disease have shown (a) subjecti ve but no objective responses to 100 mg coumarin and cimetidine daily; (b) objective responses in 3 of 40 patients treated with 3 g coumarin daily, all of whom had normal performance status and 1 of whom remain s with three resolved bone metastases and stable prostate-specific ant igen levels after 4 years; (c) toxicity only in bedridden patients. We recently initiated two multi-center trials of 1 g coumarin daily. Met astatic prostatic carcinoma patients of normal performance status were treated in a phase II trial. Patients who had been treated by radical prostatectomy, but had surgical margin, seminal vesicle or lymph node involvement or detectable prostate-specific antigen after radical pro statectomy, were randomized to coumarin or placebo.