S. Culine et al., EVALUATION OF ESTRAMUSTINE PHOSPHATE COMBINED WITH WEEKLY DOXORUBICININ PATIENTS WITH ANDROGEN-INDEPENDENT PROSTATE-CANCER, American journal of clinical oncology, 21(5), 1998, pp. 470-474
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.