TITLE:
Outcome of Combination Chemotherapy with Docetaxel, Estramustine Phosphate, and Carboplatin after Docetaxel and Prednisolone Therapy in Patients with Metastatic Castration-Resistant Prostate Cancer
AUTHORS:
Ryuichi Ito, Shintaro Narita, Hiroshi Tsuruta, Kazuyuki Numakura, Atsushi Maeno, Mitsuru Saito, Takamitsu Inoue, Norihiko Tsuchiya, Shigeru Satoh, Tomonori Habuchi
KEYWORDS:
Chemotherapy, Carboplatin, Docetaxel, Estramustine Phosphate, Prostate Cancer
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.7 No.7,
June
30,
2016
ABSTRACT: We retrospectively
reviewed the outcome of docetaxel, EMP, and carboplatin (DEC) as second-line
chemotherapy in castration-resistant prostate cancer (CRPC) patients previously
treated with docetaxel-prednisolone (DP). Nineteen patients pretreated with DP received
a DEC regimen which consisted of a 28-day cycle of docetaxel [60 mg/m2 intravenously (IV) on day 1)], carboplatin (IV to an area under the curve of 5
on day 1), and EMP (560 mg orally daily). The DEC therapy was continued
intermittently after two consecutive courses. End points were DEC effect on prostate-specific
antigen (PSA), radiographic response, progression-free survival (PFS), and
overall survival (OS). All patients received DP before DEC administration with
a median of 6 cycles (range, 1 - 12). Mean follow-up duration was 19.0 months
after starting DEC therapy; median total number of the therapy cycles was 2
(range, 1 - 11). Thirteen patients (68.4%) showed a PSA decrease; 6 (31.6%)
showed a decrease in the PSA level of ≥50%, including 4 with no PSA response to
DP. Grade 3/4 neutropenia and febrile neutropenia were observed in 13 (68.4%)
and 2 (10.5%) patients, respectively. The median PFS following DEC was 3.7
months. The median OS was 18.0 months. In univariate analyses, patients with
≤12 months from CRPC to DEC had shorter PFS and OS, whereas PSA response to DP
was not associated with PFS or OS in CRPC patients treated with DEC after DP. In
conclusion, DEC retains some clinical benefits for CRPC patients pretreated
with DP, even in patients without any response to DP. Therefore, they may be an
effective and feasible treatment option for CRPC patients after first-line
docetaxel therapy, particularly for those deemed unfit for novel endocrine and
chemotherapeutic drugs.