Weekly chemotherapy in advanced prostatic cancer

Francini, Guido; Petrioli, Roberto; Manganelli, Antonio; Cintorino, Marcella; Marsili, Stefania; Aquino, A; Mondillo, Sergio

doi:10.1038/bjc.1993.265

Cited by 27 publications

(13 citation statements)

References 31 publications

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“…We documented a palliative response rate of 48% and a median duration of response of six months, which compare favourably with the results obtained using other first-line cytotoxic drugs (table 2) [7, 8, 9, 19]. However, these preliminary results must be confirmed in the setting of a currently on-going phase III trial, which includes the study of the optimal dosage: a weekly vs. a 3-weekly schedule.…”

Section: Discussionsupporting

confidence: 81%

“…Doxorubicin has shown some activity in the treatment of patients with HRPC, and epirubicin (the 4′ epimer of doxorubicin) has proved to be effective in improving bone pain and performance status when administered alone or as part of a combination treatment [9, 10, 11]. Recent randomised trials have demonstrated better symptom palliation with the mitoxantrone+steroid combination than either prednisone or hydrocortisone [8, 12].…”

Section: Introductionmentioning

confidence: 99%

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Weekly Low-Dose Docetaxel in Advanced Hormone-Resistant Prostate Cancer Patients Previously Exposed to Chemotherapy

Petrioli¹,

Pozzessere²,

Messinese³

et al. 2003

Oncology

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Objective: The aim of this study was to evaluate the activity and tolerability of docetaxel in patients with hormone-resistant prostate cancer previously exposed to chemotherapy. Methods: We enrolled 27 patients with hormone-resistant prostatic cancer that had progressed during first-line chemotherapy. The primary end-point was palliative response defined as a 2-point reduction in the 6-point present pain intensity scale, and an improvement in Karnofsky performance status of one 10-point category. The treatment consisted of weekly docetaxel 25 mg/m² body surface area administered by means of a 1-hour intravenous infusion with corticosteroid premedication. Results: The primary criterion of palliative response was met in 13 patients (48%) after eight treatment cycles; its median duration was 6 months (range 1–8). Mean global quality of life improved in 8 and 10 patients after respectively four and eight treatment cycles. After a median follow-up of 8 months, 21 patients had died: the median survival was 9+ months (range 2–18). Weekly docetaxel was very well tolerated: grade 3 neutropenia occurred in 1 patient and grade 3 anemia in 2. Conclusions: Weekly low-dose docetaxel is an effective and well-tolerated treatment for patients with hormone-resistant prostate cancer previously exposed to chemotherapy.

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Section: Discussionsupporting

confidence: 81%

Section: Introductionmentioning

confidence: 99%

Weekly Low-Dose Docetaxel in Advanced Hormone-Resistant Prostate Cancer Patients Previously Exposed to Chemotherapy

Petrioli¹,

Pozzessere²,

Messinese³

et al. 2003

Oncology

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“…Some of the patients with bone metastasis were studied repeatedly. At each sampling time, the patients with bone metastasis were evaluated based on the finding of bone scan compared with the previous bone scan with information of symptom change, PSA value and/or other imaging modalities; new (NEW), complete remission (CR), improvement (IMP), flare-up (FLARE), no change (NC) and progression of disease (PROG) based on national prostatic cancer project response criteria (Slack and Murphy, 1984;Francini et al, 1993). NEW indicates newly diagnosed bone metastasis.…”

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confidence: 99%

Dissociation of bone formation markers in bone metastasis of prostate cancer

Koizumi

Maéda²,

Yoshimura³

et al. 1997

Br J Cancer

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Summary To clarify the meaning and clinical value of bone formation markers in bone metastasis from prostate cancer, we investigated the bone formation markers carboxy-terminal propeptide of type procollagen (PICP), bone-specific alkaline phosphatase (BAl-p) and osteocalcin, so-called bone gla protein (BGP) in 43 prostate cancer patients with and 46 patients without overt bone metastasis. Patients with bone metastasis were evaluated repeatedly by bone scan at intervals of 3-6 months. The expression patterns of bone formation markers in patients with progression of bone metastasis became dissociated; BAl -p and PICP were elevated in patients with progression of bone metastasis but BGP was not. Instead, BGP showed slight elevation in patients with improvement and complete remission of bone metastasis. PICP, BAl-p and BGP are all bone formation markers, but each marker appears in a different phase of bone formation: PICP appears in proliferation phase, BAl -p appears in matrix maturation phase and BGP appears in late bone formation phase. Our findings that BGP was not elevated in progression of bone metastasis and that it increased slightly with improvement and complete remission of bone metastasis may imply that the bone formation that occurs in blastic bone metastasis is different from normal bone formation.Keywords: prostate cancer; bone metastasis; carboxy-terminal propeptide of type procollagen; bone-specific alkaline phosphatase; bone gla protein Bone metastasis from prostate cancer is frequently osteoblastic in nature, and it often shows up as osteoplastic changes on plain radiography. Recently, various bone metabolic markers of both formation and resorption have been identified. Bone resorption markers have been proven to be useful in the bone metastasis of prostate cancer (Kylmala et al, 1995; Maeda et al, 1996). However, the meaning of bone formation markers is not fully understood in bone metastasis of prostate cancer. Various bone formation markers have been found to be associated with certain phases of bone formation. The carboxy-terminal propeptide of type I procollagen (PICP) is believed to be a marker of early bone formation and it generally appears during osteoblast proliferation. Bone-specific alkaline phosphatase (BAl-p) is a marker of the middle stage of bone formation and it appears in the matrix maturation phase. Osteocalcin, so-called bone gla protein (BGP), is a marker of late bone formation and it appears in the mineralization phase (Stein et al, 1990;Risteli and Risteli, 1993;Zhou et al, 1994;Calvo et al, 1996). To clarify the meaning of bone formation markers, we investigated these three markers in prostate cancer patients with and without overt bone metastasis. PATIENTS AND METHODSBetween October 1994 and April 1996, 43 prostate cancer patients with and 46 patients without overt bone metastasis were studied with respect to bone formation markers. Of the 46 patients without Institute Hospital, 1-37-1 Kami-lkebukuro, Toshima-ku, Tokyo 170, Japan overt bone metastasis, 29 had a history of r...

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“…The EORTC Genitourinary Group (protocol 30841) used EPR 12 mg m-2 weekly with an objective response rate (complete or partial) of only 12% (Jones et al, 1987). Francini et al (1993) presented a 37.7% response rate (bone scan, soft-tissue metastases, acid phosphatase, weight, symptoms and performance status) after EPR 30 mg m-2 weekly, and Elomaa et al (1991) demonstrated improved performance status in 69% of patients using EPR at 25 mg m-2 weekly. In order to increase efficacy, but still within a level of tolerable toxicity, higher doses of EPR have been tested.…”

Section: Toxicitymentioning

confidence: 98%

Epirubicin combined with estramustine phosphate in hormone-resistant prostate cancer: a phase II study

Hernes

Fosså²,

Vaage³

et al. 1997

Br J Cancer

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Summary Twenty-four assessable patients with hormone-resistant prostate cancer (HRPC) were to receive daily doses of oral estramustine phosphate (EMP), 10 mg kg-1, and intravenous epirubicin (EPR) infusions, 100 mg m-2, every third week up to a cumulative dose of 500 mg m-2. Biochemical response [. 50% reduction in pretreatment serum prostate-specific antigen (PSA) after three cycles of 2 3 weeks' duration] was demonstrated in 13 of 24 patients included (54%). No objective response (WHO criteria) was observed, although seven of nine evaluable patients achieved a . 50% serum PSA reduction. Subjective improvement (pain score, performance status) occurred in 7 of 24 patients, whereas nine patients progressed subjectively. There was no correlation between subjective and biochemical response.Biochemical progression (. 50% increase of nadir PSA) occurred after a median of 12 weeks. All but two patients were alive after a median follow-up time of 8.7 months for surviving patients (range 3.3-13.2). Eight patients experienced grade 3/4 leucopenia, with no indication of cumulative myelosuppression. Cardiovascular toxicity was experienced by four patients. Two patients developed angioedema twice, in one patient requiring hospitalization at the intensive ward. Based on this limited series, the combination of EPR and EMP in patients with HRPC is tolerable and appears to be effective in terms of significant PSA reduction. The results warrant further investigations of the two drugs and, in particular, of the clinical significance of . 50% PSA decrease in patients with HRPC.

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Weekly chemotherapy in advanced prostatic cancer

Cited by 27 publications

References 31 publications

Weekly Low-Dose Docetaxel in Advanced Hormone-Resistant Prostate Cancer Patients Previously Exposed to Chemotherapy

Weekly Low-Dose Docetaxel in Advanced Hormone-Resistant Prostate Cancer Patients Previously Exposed to Chemotherapy

Dissociation of bone formation markers in bone metastasis of prostate cancer

Epirubicin combined with estramustine phosphate in hormone-resistant prostate cancer: a phase II study

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