Metronomic therapy with cyclophosphamide and dexamethasone for prostate carcinoma

• Published in: Cancer Vol. 98; no. 8; pp. 1643 - 1648
• Main Authors: Glode, L. Michael, Barqawi, Albaha, Crighton, Frances, Crawford, E. David, Kerbel, Robert
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 15.10.2003; Wiley-Liss
• Subjects: Aged; Aged, 80 and over; Antineoplastic agents; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; Chemotherapy; cyclophosphamide; Cyclophosphamide - administration & dosage; dexamethasone; Dexamethasone - administration & dosage; Humans; Male; Medical sciences; metronomic; Middle Aged; Pharmacology. Drug treatments; prostate carcinoma; Prostate-Specific Antigen - blood; Prostatic Neoplasms - drug therapy; Retrospective Studies; Antineoplastic agent; Carcinoma; Prostate disease; Toxicity; Administration schedule; Glucocorticoid; metronomic; Complication; Male genital diseases; Human; Corticosteroid; Drug combination; Urinary system disease; Dexamethasone; Steroid hormone; Treatment efficiency; Oral administration; Malignant tumor; Alkylating agent; Chemotherapy; Cyclophosphamide; Oxazaphosphinane derivatives; Treatment; Nitrogen mustard; Prostate; prostate carcinoma
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/cncr.11713

BACKGROUND The current study was designed to evaluate the efficacy and toxicity of the continuous oral administration of a combination of cyclophosphamide (50 mg/day given in the morning) and dexamethasone (1 mg/day given in the evening) in patients with prostate specific antigen (PSA) progression despite single or multiagent hormone therapy and antiandrogen withdrawal. METHODS The authors retrospectively evaluated the medical records of all patients with prostate carcinoma who were treated with dexamethasone and cyclophosphamide and who were unable to participate in Phase II drug trials or had failed previous chemotherapy regimens. RESULTS Using clinical response guidelines set forth by the Prostate Specific Antigen Working Group, 29% of patients were found to have a ≥ 80% reduction in PSA, 39% were found to have a 50–79% reduction in PSA, 6% were found to have a < 50% decrease in PSA, and 26% experienced disease progression while receiving treatment. The duration of response was 8 months (95% confidence interval [95% CI], 4–10 months). The duration of treatment was 9 months (95% CI, 6–14 months). The treatment was reported to be well tolerated with side effects being primarily bruising, Cushingoid facies, and gastrointestinal distress. CONCLUSIONS In the current study, low‐dose dexamethasone and cyclophosphamide demonstrated efficacy as salvage therapy in the treatment of patients with hormone‐refractory prostate carcinoma. Cancer 2003. © 2003 American Cancer Society. DOI 10.1002/cncr.11713 In the current study, low‐dose dexamethasone and cyclophosphamide were found to demonstrate efficacy as salvage therapy in the treatment of patients with hormone‐resistant prostate carcinoma. See also pages 1559–61.