Response to Docetaxel/Carboplatin in Patients with Hormone-Refractory Prostate Cancer Not Responding to Taxane-Based Chemotherapy

• Published in: Clinical prostate cancer Vol. 4; no. 1; pp. 61 - 64
• Main Authors: Oh, William K., George, Daniel J., Tay, Miah-Hiang
• Format: Journal Article
• Language: English
• Published: United States 01.06.2005
• Subjects: Aged; Androgen deprivation therapy; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Carboplatin - administration & dosage; Disease Progression; Drug Resistance, Neoplasm; Humans; Male; Middle Aged; Neuroendocrine differentiation; Prednisone; Prostate-specific antigen; Prostate-Specific Antigen - blood; Prostatic Neoplasms - drug therapy; Prostatic Neoplasms - pathology; Survival Analysis; Taxoids - administration & dosage; Taxoids - pharmacology; Taxoids - therapeutic use; Treatment Outcome; Prednisone; Androgen deprivation therapy; Neuroendocrine differentiation; Prostate-specific antigen
• ISSN: 1540-0352; 2374-8435
• DOI: 10.3816/CGC.2005.n.014

Few treatment options are available for patients with metastatic hormone- refractory prostate cancer (HRPC) that is not responsive to or continues to progress after taxane-based chemotherapy. Although single-agent carboplatin has modest activity in HRPC, carboplatin chemotherapy could induce a synergistic effect when combined with taxanes in patients with disease resistant to taxane-based chemotherapy. We report a case series of 4 consecutive patients treated with docetaxel (60-70 mg/m2) plus carboplatin (area under the curve of 4/5) following progression after taxane-based chemotherapy. Prostate-specific antigen levels decreased by > 50% in all 4 patients and were associated with improvement in symptoms in 3 of 4 patients. Treatment was well tolerated, with fatigue as the most common reported side effect. Patients received 4-11 cycles of treatment and, after initiation of docetaxel/carboplatin chemotherapy, survival ranged from 4.5 months to 12 months. In this small series, there is a suggestion of a greater than expected response with carboplatin and docetaxel for patients who exhibit disease progression despite taxane-based chemotherapy or do not respond to therapy. A clinical trial to evaluate this effect has been initiated.