Clinical experience with intravenous estramustine phosphate, paclitaxel, and carboplatin in patients with castrate, metastatic prostate adenocarcinoma Journal Article
| Authors: | Solit, D. B.; Morris, M.; Slovin, S.; Curley, T.; Schwartz, L.; Larson, S.; Kattan, M. W.; Hartley-Asp, B.; Scher, H. I.; Kelly, W. K. |
| Article Title: | Clinical experience with intravenous estramustine phosphate, paclitaxel, and carboplatin in patients with castrate, metastatic prostate adenocarcinoma |
| Abstract: | BACKGROUND. The combination of paclitaxel, oral estramustine phosphate (EMP), and carboplatin (TEC) has shown antitumor activity in patients with castrate, metastatic prostate carcinoma. To improve the therapeutic efficacy and reduce the toxicity of TEC, the authors substituted intravenous (i.v.) EMP for oral EMP based on single-agent studies demonstrating an improved safety profile with i.v. EMP. METHODS. Patients with progressive, castrate, metastatic prostate carcinoma were treated with up to 6 4-week cycles of i.v. EMP (500-1500 mg/m2 per week), paclitaxel (100 mg/m2 per week), and carboplatin (target area under the curve = 6 mg/mL every 4 weeks). RESULTS. Thirty patients were treated in 6 dose cohorts. Deep venous thrombosis occurred in 5 of 30 patients (17%). Other common Grade 3/4 (according to National Cancer Institute Common Toxicity Criteria) toxicities included hepatic toxicity (23%) and leukopenia (24%). Posttherapy prostate specific antigen declines > 50% were seen in 18 of 30 patients (60%), and declines > 80% were seen in 15 of 30 patients (50%). Eleven of 17 patients (65%) with measurable soft tissue disease achieved a partial response. Four of 27 patients (15%) with osseous metastases demonstrated improvement on bone scan. CONCLUSIONS. Intravenous EMP was administered safely with paclitaxel and carboplatin and produced clinical outcomes similar to the outcomes achieved with the TEC regimen. Substitution of i.v. EMP for the oral formulation was found to result in a lower incidence of severe nausea but increased hepatic toxicity. © 2003 American Cancer Society. |
| Keywords: | adult; clinical article; treatment outcome; aged; bone neoplasms; disease-free survival; middle aged; clinical trial; constipation; fatigue; cancer combination chemotherapy; diarrhea; dose response; drug efficacy; drug safety; hypophosphatemia; bone metastasis; paclitaxel; chemotherapy; adenocarcinoma; prostate specific antigen; carboplatin; edema; liver toxicity; anemia; gastrointestinal symptom; leukopenia; nausea; thrombocytopenia; antineoplastic combined chemotherapy protocols; drug administration schedule; deep vein thrombosis; hyperglycemia; rash; prostate-specific antigen; prostatic neoplasms; chemotherapy induced emesis; thromboembolism; thrombosis; neoplasm metastasis; prostate adenocarcinoma; sensory dysfunction; infusions, intravenous; epistaxis; metabolic disorder; urticaria; heart muscle ischemia; hematologic disease; bone scintiscanning; prostate carcinoma; kidney dysfunction; estramustine; estramustine phosphate; humans; human; male; priority journal; article |
| Journal Title: | Cancer |
| Volume: | 98 |
| Issue: | 9 |
| ISSN: | 0008-543X |
| Publisher: | Wiley Blackwell |
| Date Published: | 2003-05-01 |
| Start Page: | 1842 |
| End Page: | 1848 |
| Language: | English |
| DOI: | 10.1002/cncr.11754 |
| PUBMED: | 14584065 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Export Date: 12 September 2014 -- Source: Scopus |
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