Departments of Clinical Therapeutics and Urology, University of Athens Medical School, Athens, Greece.

Department of Urology, Amalia Fleming Hiospital, Athens, Greece; Department of Urology, Polykliniki Hospital, Athens, Greece.

Docetaxel is an effective first-line treatment for hormone-refractory prostate cancer. Nevertheless, the prognosis subsequent to progression after first-line therapy is poor and no second-line treatment has been established.

A total of 34 patients with androgen-independent prostate cancer received doxorubicin, 30 mg/m(2), every 2 weeks and ketoconazole daily, 400 mg orally every 8 hours. All patients had been treated with docetaxel and had disease progression within 6 months after completion of first-line treatment.

Of the 32 evaluable patients, 13 (43.7%, 95% confidence interval [CI] 26.3% to 62.3%) had a prostate-specific antigen (PSA) response, and 4 (28%, 95% CI 8.4% to 58.1%) of 14 patients with measurable disease had a response to therapy. The median time to progression (TTP) was 3.9 months (95% CI 2.0 to 5.9), and the median overall survival (OS) was 13 months (95% CI 8.7 to 17.3). Toxicity was mild, with only 4 cases of nonhematologic grade 3 or 4 toxicity. The most frequent toxicity was nail changes (33 of 34 patients), which was mainly grade 1 (30 cases).

The combination of biweekly doxorubicin and ketoconazole is an effective, well-tolerated, second-line therapy for hormone-refractory prostate cancer.

Written by
Lainakis G, Nikos A, Gerassimos A, Michael C, Iraklis M, Konstantinos L, Ioannis V, Harilaos K, Dimopoulos MA, Bamias A.

Reference
Urology. 2008 Apr 7. Epub ahead of print
doi:10.1016/j.urology.2008.02.048

PubMed Abstract
PMID:18400264

UroToday.com Prostate Cancer Section

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