Combination of epirubicin and cisplatin in hormone-refractory metastatic prostate cancer

Anthracyclines and cisplatin have been shown separately to have modest acti vity in prostate cancer. The synergism between anthracyclines and cisplatin , with the lack of overlapping toxicities, led to the conduct of this phase II trial of the combination of epirubicin and cisplatin in hormone-refract ory metastatic prostate cancer. Twenty-one evaluable patients with hormone- refractory metastatic prostate cancer received epirubicin 100 mg/m(2) follo wed by cisplatin 80 mg/m(2) with prehydration and mannitol diuresis. Epirub icin and cisplatin produced a biochemical response (>50% decrease in tumor marker) in 32% of patients, symptomatic improvement in 38%, and a response in measurable and evaluable disease sites in 14%. Toxicities were mainly he matologic, with 77% and 41% >grade 2 neutropenia and thrombocytopenia, resp ectively. Greater than grade 2 toxicities were: cardiac (three), renal seco ndary to sepsis (one), nausea and vomiting (two), weakness (one), mucositis (one), and diarrhea (one). The combination of epirubicin and cisplatin was associated with manageable toxicities in this elderly population; however, antitumor activity was marginal in this disease. Participation in clinical trials should continue to be offered to patients with hormone-refractory m etastatic prostate cancer.