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Satraplatin is a novel oral platinum (IV) complex that shows activity against hormone-refractory prostate cancer (HRPC) in cisplatin-resistant human tumor lines in phase I and phase II trials [1]. A randomized multicenter phase III trial with a target sample size of 380 patients was initiated in men with HRPC. After 50 randomized patients, the trial was closed to further accrual by the sponsoring company. An ad hoc analysis of all available data is reported here. Eligibility criteria included pathological proof of prostate cancer, documented progression despite prior hormonal manipulation, WHO PS 0–2, and no daily intake of narcotic analgesics. Patients were randomized between satraplatin 100 mg/m² for 5 days plus prednisone 10 mg orally BID or prednisone alone. Compliance was excellent. 48/50 patients have progressed and 42 have died, mostly due to prostate cancer. Median overall survival was 14.9 months (95% CI: 13.7–28.4) on the satraplatin plus prednisone arm and 11.9 months (95% CI: 8.4–23.1) on prednisone alone (hazard ratio, HR = 0.84, 95% CI: 0.46–1.55). A >50% decrease in prostrate specific antigen (PSA) was seen in 9/27 (33.3%) in the satraplatin plus prednisone arm vs. 2/23 (8.7%) on the prednisone alone arm. Progression-free survival was 5.2 months (95% CI: 2.8–13.7) on the satraplatin plus prednisone arm as compared to 2.5 months (95% CI: 2.1– 4.7) on the prednisone alone arm (HR = 0.50, 95% CI: 0.28–0.92). This difference is statistically significant (p = 0.023). Toxicity was generally minimal in both arms. This randomized comparison of a combination of satraplatin and prednisone versus prednisone alone supports the antitumor activity of the combination. Its role in the treatment of HPRC remains to be elucidated in an appropriate phase III setting.

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IntroductionKetamine is a derivative of phencyclidine and is a dissociative anaesthetic. Its use as a recreational drug is on the increase among young adults attending clubs and parties.Case presentationWe describe the case of a 20-year-old man who presented with a 7-month history of urinary frequency, nocturia, urgency, suprapubic discomfort during micturition and episodes of severe haematuria shortly after commencing weekly recreational ketamine use. Complementary examinations were negative except for a thickened bladder wall on ultrasound examination and mild inflammatory changes on cystoscopy. So far only nine cases of ketamine-associated ulcerative cystitis have been described.ConclusionWe expect that in the future an increasing number of cases of cystitis caused by ketamine use will be seen in young adults.

The standard treatment for patients with castration-refractory prostate cancer (CRPC) is the combination docetaxel-prednisone, if the patient can support chemotherapy. Several new treatments have been tested in chemotherapy-naïve or docetaxel-pretreated patients with CRPC. Some of these treatments have shown activity in first-line and second-line treatment. In this review, an update is given of new treatment studies performed in patients with CRPC.