Taplin, Mary-Ellen;
Xie, Wanling;
Bubley, Glenn J.;
Ernstoff, Marc S.;
Walsh, William;
Morganstern, Daniel E.;
Regan, Meredith M.
Docetaxel, Estramustine, and 15-Month Androgen Deprivation for Men With Prostate-Specific Antigen Progression After Definitive Local Therapy for Prostate Cancer
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Medientyp:
E-Artikel
Titel:
Docetaxel, Estramustine, and 15-Month Androgen Deprivation for Men With Prostate-Specific Antigen Progression After Definitive Local Therapy for Prostate Cancer
Beteiligte:
Taplin, Mary-Ellen;
Xie, Wanling;
Bubley, Glenn J.;
Ernstoff, Marc S.;
Walsh, William;
Morganstern, Daniel E.;
Regan, Meredith M.
Erschienen:
American Society of Clinical Oncology (ASCO), 2006
Beschreibung:
<jats:sec><jats:title>Purpose</jats:title><jats:p> Androgen-deprivation therapy (ADT) is effective for relapsed prostate cancer, but is rarely curative. The purpose of this trial was to determine the feasibility, toxicity, and prostate-specific antigen (PSA) response of chemotherapy and limited ADT for men with PSA relapse. </jats:p></jats:sec><jats:sec><jats:title>Patients and Methods</jats:title><jats:p> Eligible men had an increasing PSA and no metastases after prostatectomy and/or radiation for localized disease. Treatment consisted of four cycles of docetaxel (70 mg/m<jats:sup>2</jats:sup>) every 21 days and estramustine 280 mg tid on days 1 through 5. After chemotherapy, goserelin acetate and bicalutamide were prescribed for 15 months. </jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p> Sixty-two patients were enrolled. A complete PSA response (CR) was defined as PSA at or below the assay-specific lower limit. The proportion of patients with CR after chemotherapy, after ADT, and at 1 year after completion of ADT was 53%, 63%, and 36%, respectively. Testosterone was more than 100 ng/dL (median, 250 ng/dL) 1 year after completion of ADT in 97% of patients. Patients with a PSA less than 3.0 ng/mL at enrollment had a significantly longer time to progression (TTP; P = .0004). Of 56 patients who were observed at least 1 year after completion of ADT, 23 (41%) have not experienced progression as of their last follow-up. The median TTP is 34 months from treatment initiation (maximum, 74 months free from progression). </jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p> Chemotherapy plus ADT was feasible for early prostate cancer relapse. Forty-one percent of men who are at least 1 year after completion of ADT with recovered testosterone have not experienced progression. This approach is being tested in a randomized trial with investigation of predictors of response. </jats:p></jats:sec>