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Chemotherapy Updates
Where There Was a Sequence of Treatments Involved
The following
studies cover emcyt after other estrogenic agents, docetaxel after
mitoxantrone, a response to taxotere after taxol(table 3) and adding
carboplatin to taxotere to get a continued response (table 4.)
Table
1. Response to Emcyt after Prior Estrogenic Agents.
|
Ref
|
Phase, Number of Patients |
PSA Response Rate to estrogenic agents |
Response rate to Emcyt after prior treatment with estrogenic agents like
DES or PC SPES |
PSA
Response Rate
>50% |
Median Response Rate |
Median time to progression or median survival |
|
(1)* |
None, 25 |
54% |
60% |
Not reported |
Not reported |
Median overall survival 12.7 months |
(1)
Garcia JA,
Weinberg V, Small EJ. Prior estrogen therapy as a predictor of response to
subsequent estramustine-based chemotherapy in patients with
androgen-independent prostate cancer. Clin. Prostate Cancer. 2005
Sep;4(2):113-7.
*The authors conclude that previous response to second-line
hormonal maneuvers with estrogen based therapy does not predict subsequent
response to Emcyt-based chemotherapy.
Table
2. Docetaxel/emcyt after Mitoxantrone/pednisone.
|
Ref |
Phase, Number of Patients |
Mitoxantrone/
prednisone
Docetaxel/emcyt |
Docetaxel/emcyt AFTER mitoxantrone/prednisone |
PSA
Response Rate
>50% |
Median Response Rate |
Median time to progression or median survival |
|
(1) |
None, 30 |
10 mg/m2 day 1 every three weeks, prednisone 5 mg twice daily for three
days |
After 3 cycles of mitoxantrone/prednisone then emcyt 280 mg three times
daily days 1 to 5, plus docetaxel 75 mg/m2 day 2, every three weeks for
max of 10 cycles |
63% |
|
Progression free 10 months, at 18 month follow-up median survival was 18
months |
(1)
Font A,
Murias A, Arroyo FR, Martin C, Areal J, Sanchez JJ, Santiago JA, Constenia
M, Saladie JM, Rosell R. Sequential mitoxantrone/prednisone followed by
docetaxel/ estramustine in patients with hormone refractory metastatic
prostate cancer: results of a phase II study. Ann. Oncol. 2005
Mar;16(3):419-24. Epub 2005 Jan 24.
Table 3. Docetaxel/Emcyt/Carboplatin
After Paclitaxel-based chemotherapy.
|
Ref |
Phase, No of patients |
Docetaxel plus emcyt plus carboplatin |
PSA decline >50% |
Median time to progression or survival |
|
(1) |
None; 15 who displayed disease progression while receiving paclitaxel-based
combination chemo |
Docetaxel 30 mg/m2 weekly, oral emcyt 10 mg/kg daily and intravenous
carboplatin (dosed to an area under the curve of 6) on day 1 of a four
week cycle. |
33.3% |
Median time to progression 25 weeks; median overall survival 54 weeks. |
(1) Urakami S, Yoshino T, Kikuno N, Imai S, Honda S, Yoneda T, Kishi H,
Shigeno
K, Shiina H, Igawa M.Docetaxel-based chemotherapy as second-line
treatment
for paclitaxel-based chemotherapy-resistant hormone-refractory
prostate
cancer: a pilot study. Urology. 2005 Mar;65(3):543-8.
Table
4. Docetaxel plus carboplatin After Failing Taxane-based chemotherapy.
|
Ref
|
Phase, Number of Patients |
Docetaxel |
Carboplatin |
PSA
Response Rate
>50% |
Median Response Rate |
Median time to progression or median survival |
|
(1) |
None, 4 who had progressed after taxane-based chemotherapy |
60-70 mg/m2 |
Area under the curve of 4/5 |
100% |
not reported |
Survival ranged from 4.5 months to 12 months |
(1)
Oh WK,
George DJ, Tay MH. Response to docetaxel/carboplatin in patients with
hormone-refractory prostate cancer not responding to taxane-based
chemotherapy. Clin Prostate Cancer. 2005 Jun;4(1):61-4.
Author:
Barb Minton
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