Outcome of second-line chemotherapy with a combination of docetaxel and carboplatin (DC) in docetaxel-resistant (DR) hormone refractory prostate cancer (HRPC) patients

Abstract

16090 Background: Docetaxel is the standard chemotherapy for HRPC. However, a standard protocol has not yet been defined for patients with DR disease. Initial reports support the use of carboplatin (C) in combination with docetaxel (D) in these patients (pts). Methods: Metastatic HRPC pts that were resistant to treatment with D were included in our retrospective analysis. Between February 2005 and December 2007, 17 pts received treatment with C AUC 5 q3wks in combination with D 75 mg/m2 q3wks or D 35 mg/m2 d1, d8, d15 q4wks. 3 pts additionally received estramustine 140 mg on 3 consecutive days in parallel to weekly applications of D. All pts were assessed for PSA response and clinical outcome. Results: Seventeen pts were identified at our institution for analysis. The median follow-up was 13 months (range: 0–31) with a median number of 4 cycles administered (range: 1–16). PSA reduction >50% was achieved in 9 pts (53%) and PSA stabilization in 5 pts (29%). 4 pts (24%) progressed without PSA response. The median duration of PSA response was 19 wks. Pts with PSA normalization or >90% reduction tended to achieve a longer PSA response (median 79 wks, range: 18–80) compared to pts with PSA stabilization or reduction by 50–90% (20 wks, range: 4–57). The most common grade 3/4 toxicities were neutropenia in 29% and thrombocytopenia in 11% of pts. Conclusions: This retrospective analysis supports the usefulness of second-line chemotherapy in HRPC. DC shows promising activity in DR pts with clinically meaningful responses. Patient Characteristics ECOG 0, No. of patients (%) 13 (76%) ECOG 1, No. of patients (%) 3 (18%) ECOG 2, No. of patients (%) 1 (6%) Liver metastases, No. of patients (%) 4 (24%) Visceral or lymphatic metastases, No. of patients (%) 6 (35%) Pain, No. of patients (%) 12 (71%) ≥2 metastatic sites, No. of patients (%) 7 (41%) Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Expert Testimony Other Remuneration sanofi-aventis