USE OF INTRAVENOUS FOSFESTROL TETRASODIUM (HONVAN) INFUSION IN TREATMENT OF SYMPTOMATIC ADVANCED PROSTATE-CANCER

Fosfestrol tetrasodium (Honvan) is a synthetic oestrogen-based compoun d. Studies have suggested its use in the treatment of localised, advan ced and hormone-refractory prostate cancer. This series of 17 patients with advanced disease documents the response, both subjective and obj ective, to standard dose intravenous Honvan infusion. Infusions were w ell tolerated, with no cardiovascular side-effects. Twelve patients re ceived Honvan as de novo therapy of whom 10 (83%) described subjective improvement and 11 (92%) had objective evidence of improvement, 11 (9 2%) had documented falls in prostate-specific antigen (PSA) levels. Ni ne patients received Honvan infusions as secondary treatment for hormo ne-escaped disease (1 patient received Honvan for a second time and an other for a second and third time). Of these, 1 (11%) had a documented fall in PSA; 3 (33%) reported a subjective symptomatic improvement, a nd 2 (22%) demonstrated objective evidence of improvement. Patients wi th symptoms from bulk abdomino-pelvic disease seemed to fare better th an those with bony metastases. This may suggest a specific indication for Honvan in a subgroup of patients with acute obstructive events of the ureters, urethra or circulatory vessles, in particular its value a s a de novo therapy. In those patients who received Honvan as secondar y therapy, some response was seen in a third, but overall these patien ts remained hormone-refractory.