Docetaxel And Cisplatin In Patients With Metastatic Androgen Independent Prostate Cancer And Circulating Neuroendocrine Markers

Main Category: Prostate / Prostate Cancer
Also Included In: Urology / Nephrology;  Men's health
Article Date: 02 Sep 2007 - 0:00 PDT

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UroToday.com- A subset of patients with androgen-independent prostate cancer (AICaP) has elevated levels of neuroendocrine markers such as chromogranin A and neuron specific enolase. Dr. Culine and associates in France evaluated the combination of docetaxel and cisplatin chemotherapy in these patients and report their results in the July 2007 early view of the Journal of Urology.

Between 2001 and 2004 41 patients with AICaP and elevated NE markers were treated with docetaxel and cisplatin chemotherapy and monitored for response and toxicity. A total of 24 men (58%) had received at least 2 successive hormonal therapies for metastatic disease prior to study entry. A median of 6 cycles of chemo were given per patient. Grade 3-4 neutropenic toxicity occurred in 35% of courses and grade 3-4 non-hematological toxicities occurred in 30 patients. Five men stopped therapy due to toxicity including one death due to septic shock. Quality of life due to asthenia and/or neuropathy was evident in all 23 men who completed all 6 cycles of chemotherapy.

Following chemotherapy a decrease in neuroendocrine markers to 50% or greater of the baseline levels was found in 33% of patients. The median response was 4 months. A decrease in PSA to 50% or greater of the baseline was found in 48%. In men with measurable metastasis a total of 41% had a partial response and a clinical benefit was observed in 45% of patients who required analgesics at study entry. At the end of observation all except 3 patients had died, 37 of progressive CaP, and 1 from toxicity. Median time to disease progression was 8 months and median survival was 12 months. This toxicity and efficacy do not warrant the use of this combination of chemotherapy in patients with AICaP and elevated neuroendocrine markers.

Culine S, El Demery M, Lamy PJ, Iborra F, Avancès C, Pinguet F

J Urol. ePub: July 16, 2007
DOI: 10.1016/j.juro.2007.05.044

Reported by UroToday.com Contributing Editor Christopher P. Evans, M.D

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