EVALUATION OF ESTRAMUSTINE PHOSPHATE COMBINED WITH WEEKLY DOXORUBICININ PATIENTS WITH ANDROGEN-INDEPENDENT PROSTATE-CANCER

Thirty-one patients with progressive metastatic prostate cancer refrac tory to first- or second-line hormonal therapy were treated with a com bination of daily oral estramustine phosphate (600 mg) and weekly intr avenous doxorubicin (20 mg/m(2)). Eighteen (58%) patients demonstrated a biologic response with a 50% or more serum prostate-specific antige n decline. The median duration of biologic response was three months. Five (45%) of the 11 patients with measurable lesions achieved a parti al response in liver or retroperitoneal lymph nodes. The median durati on of these objective responses was four months. Of 22 patients who re quired analgesics at the onset of the study, six (27%) achieved a sign ificant reduction of pain. The combination of doxorubicin and estramus tine phosphate was tolerated on an outpatient schedule. The occurrence of severe toxicities required suspension of therapy in six patients. At the end of the observation time, all patients but one had died, 29 of progressive prostatic cancer and one of toxicity. The median surviv al time from the onset of chemotherapy was 12 months. The administrati on of weekly doxorubicin with phosphate estramustine appears to be a s afe combination for those patients with hormone-resistant prostate can cer who require chemotherapy, The benefit of chemotherapy should be in vestigated using relevant quality-of-life criteria in future trials.