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Response to docetaxel/carboplatin-based chemotherapy as first- and second-line therapy in patients with metastatic hormone-refractory prostate cancer.

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

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

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

Published 10 January 2008 in BJU Int, 101(3): 308-12.
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