Lank Center for Genitourinary Oncology, Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA 02115, USA

To evaluate the efficacy of docetaxel/carboplatin (DC)-based chemotherapy as first- and second-line chemotherapy for patients with hormone-refractory prostate cancer (HRPC).

We retrospectively identified all patients with HRPC treated with DC-based chemotherapy at the Dana-Farber Cancer Institute. Regimens either included estramustine (EDC) or not (DC). We identified patients who received EDC as first-line chemotherapy and patients who received DC as second-line or subsequent chemotherapy. Patients treated with EDC received 20-70 mg/m(2) docetaxel every 1-4 weeks, estramustine 140 mg three times daily and carboplatin (area under the curve, AUC), (4-6) every 3-4 weeks. Patients treated with DC received docetaxel 50-70 mg/m(2) and carboplatin AUC (4-6) every 3-4 weeks.

In all, the study included 54 patients; 24 received EDC and 30 DC (median age 62.8 and 66.9 years, respectively); their prostate-specific antigen (PSA) level at the start of chemotherapy was 112.7 and 213.3 ng/mL, respectively. There were declines of >or=50% in PSA level in 88% and 20% in the two groups, respectively. The median overall survival was 17.7 and 14.9 months in the EDC and DC groups, respectively. The most common reversible grade 4 toxicity with either regimen was neutropenia (4% and 7% in EDC and DC, respectively).

DC-based chemotherapy is well tolerated and active in HRPC. Adding carboplatin to docetaxel provides an additional activity in 20% of patients as a second-line or subsequent chemotherapy.

Written by
Nakabayashi M, Sartor O, Jacobus S, Regan MM, McKearn D, Ross RW, Kantoff PW, Taplin ME, Oh WK.

Reference
BJU Int. 2008 Feb;101(3):308-12
doi:10.1111/j.1464-410X.2007.07331.x

PubMed Abstract
PMID:18184327

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