Weekly docetaxel, estramustine phosphate and low-dose dexamethasone in Japanese men with hormone refractory prostate cancer

Abstract

4789 Background: Recently, docetaxel have shown promising clinical results in patients with hormone-refractory prostate cancer (HRPC). However, their optimal treatment schedule has not been established. The current study determined the efficacy and toxicity of weekly docetaxel, estramustine phosphate (EMP), and low-dose dexamethasone in men with HRPC. Methods: Eligible patients had castrate testosterone levels and evidence of progressive HRPC after hormone therapy. Prior chemotherapy was allowed; including prior EMP. Patients with progressive HRPC received 25mg/m docetaxel weekly for 3 weeks, followed by a 1-week treatment rest. Patients were treated with EMP 560 mg/day and dexamethasone 1 mg PO daily. All patients did not receive commonly corticosteroid premedication. Results: Data on the first 22 patients are available. The median age was 71 (54–83), median PS 0 (0–1), and median PSA at study entry 205 ng/ml (16–1400). Bone metastases were present in 19/22 pts (86%); Patients received an average of 6.0 cycles of therapy. 16/22 (72.7%) had 50% PSA reduction; 11/22 (50%) had 75% PSA reduction, and 6 patients (27.2%) had normalization of PSA. Maximum response occurred after 3.5 cycles. Grade 3–4 toxicities were uncommon. Only 3 patients (11.7%) experienced Grade 3 anemia. No patients had leucopenia and neutropenic fever. Other toxicities were all < Grade 2. Conclusions: A combination of low dose of weekly docetaxel, daily estramustine plus low dose of oral dexamethasone has demonstrated promising efficacy and tolerability in HRPC patients with a history of extensive prior treatment. No significant financial relationships to disclose.