THE EXPERIENCE WITH SURAMIN IN ADVANCED PROSTATE-CANCER

Suramin is a new experimental polyanionic compound that has shown evid ence of antitumor activity in patients with hormone refractory prostat e cancer. After a few years of Phase I and Phase II testing, much of t he drug's toxicity pattern has been carefully characterized. Similarly , pharmacologic studies have defined many of the drug's complex pharma cologic properties to the extent that simple outpatient methods of dru g administration can be easily accomplished. A pharmacologically deriv ed, fixed outpatient schedule has been shown to be safe and effective and is currently in active Phase III development in prostate cancer an d will provide more definitive data regarding the role of suramin in t he treatment of this disease. Despite these accomplishments, a number of questions require further study, such as definition of pharmacodyna mic correlations, effects on the hypothalamic-pituitary-adrenal and go nadal axis, and the nature of its most common dose-limiting toxicity, which is a syndrome of malaise and fatigue.