Docetaxel and estramustine
compared with mitoxantrone and prednisone for advanced refractory prostate cancer.
Data from two studies presented at the annual meeting of the American Society of Clinical Oncology showed that docetaxel, alone or in combination with estramustine
, can add several months to the mean survival time for men with advanced, hormone-refractory prostate cancer.
Neither docetaxel or estramustine
is likely to radically change the prognosis for men with advanced disease, but the findings are likely to shake many urologic oncologists out of their intellectual boxes.
Drugs that might interfere with the results of monitoring tests Antineoplastic drugs Other drugs Azacitidine Atropine Busulfan Chloral hydrate Chlorambucil Chlordiazepoxide Cisplatin Chlorpromazine Cyclophosphamide Cimetidine Cytarabine Diazepam Dacarbazine Dobutamine Dibromodulcitol Dopamine Estramustine
Ephedrine Floxuridine Fentanyl Fludarabine Haloperidol Fluorouracil Hydroxyzine Ifosfamide Meperidine Lomustine Metoclopramide Mercaptopurine Midazolam Methotrexate Morphine Streptozocin Pentobarbital Thiopeta Phenylephrine Prochlorperazine Promethazine Ranitidine Scopolamine Secobarbital Temazepam
* For men with hormone-refractory prostate cancer, the use of docetaxel (Taxotere, Rhone-Poulenc Rorer) plus the nitrogen mustard estramustine
phosphate (Emcyt, Pharmacia & Upjohn) appears to help men whose prostate cancers no longer respond to treatment with synthetic estrogen and antiandrogens.
Aside from mitoxantrone and glucocorticoids, current trials are focusing on ketoconazole, estramustine
phosphate, vinblastine, and suramin (Vogelzang et al., 1998; Waselenko & Dawson, 1997).
Chemotherapeutic agents, including cyclophosphamide, doxorubicin, 5-fluorouracil, dacarbazine, cisplatin, estramustine
, and streptozocin, alone or in combination, have produced disappointing overall response rates of approximately 30% (in those with mostly stable disease, with few complete or partial responses), with median survivals of 26 to 33 weeks. In one European trial of 29 patients with advanced, hormone-resistant prostate cancer, single-agent mitomycin C was associated with a total objective response rate of 59% and an actuarial median survival time of 10.8 months. The possibility of combination chemotherapy is a logical extensive of the finding of modest activity with several single agents.
A US National Cancer Institute-sponsored study combines strontium-89 with either docetaxel with prednisone or the ketoconazole, adriamycin, vinblastine, and estramustine
A parallel study comparing Taxotere and estramustine
(Emcyt), an antineoplastic compound that contains estradiol and is approved for prostate cancer, to mitoxantrone and prednisone found about a 1.9 month survival advantage for the patients receiving Taxotere, said Dr.
4C only during treatment with Taxane/ estramustine
and was not detected before or after treatment.
Increase of [Beta]III- and Beta]IVa-tubulin isotypes in human prostate carcinoma cells as a result of estramustine
Sissung et al., "Pre-clinical and clinical evaluation of estramustine
, docetaxel and thalidomide combination in androgen-independent prostate cancer," BJU International, vol.