Results of a Phase II Study With Doxorubicin, Etoposide, and Cisplatin in Patients With Fully Characterized Small-Cell Carcinoma of the Prostate

• Published in: Journal of clinical oncology Vol. 20; no. 14; pp. 3072 - 3080
• Main Authors: PAPONDREOU, Christos N, DALIANI, Danai D, THALL, Peter F, TU, Shi-Ming, XUEMEI WANG, REYES, Adriana, TRONCOSO, Patricia, LOGOTHETIS, Christopher J
• Format: Journal Article
• Language: English
• Published: Baltimore, MD American Society of Clinical Oncology 15.07.2002; Lippincott Williams & Wilkins
• Subjects: Aged; Antineoplastic agents; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; Biomarkers, Tumor - blood; Carcinoma, Small Cell - blood; Carcinoma, Small Cell - drug therapy; Carcinoma, Small Cell - secondary; Chemotherapy; Cisplatin - administration & dosage; Disease Progression; Doxorubicin - administration & dosage; Drug Administration Schedule; Etoposide - administration & dosage; Humans; Infusions, Intravenous; Liver Neoplasms - secondary; Lung Neoplasms - secondary; Lymphatic Metastasis; Male; Medical sciences; Middle Aged; Multivariate Analysis; Pharmacology. Drug treatments; Proportional Hazards Models; Prostatic Neoplasms - blood; Prostatic Neoplasms - drug therapy; Prostatic Neoplasms - pathology; Survival Analysis; Treatment Outcome; Antineoplastic agent; Intravenous administration; Prostate disease; Toxicity; Doxorubicin; Isomerases; Phase II trial; Complication; Male genital diseases; Small cell carcinoma; Platinum II Complexes; Human; DNA topoisomerase (ATP-hydrolysing); Drug combination; Urinary system disease; Enzyme; Treatment efficiency; Etoposide; Enzyme inhibitor; Malignant tumor; Cisplatin; Podophyllotoxine derivatives; Alkylating agent; Antibiotic; Chemotherapy; Treatment; Anthracyclins; Prostate
• ISSN: 0732-183X; 1527-7755
• DOI: 10.1200/JCO.2002.12.065

To determine the activity and toxicity of doxorubicin in combination with cisplatin and etoposide in patients with small-cell prostate carcinoma (SCPCa) and to characterize the clinicopathologic features of SCPCa. Patients with SCPCa (pure or mixed), measurable disease, good organ function, and no prior treatment with doxorubicin, etoposide, or cisplatin were treated every 4 weeks with doxorubicin 50 mg/m(2) as a 24-hour intravenous (IV) infusion followed by etoposide 120 mg/m(2)/d and cisplatin 25 mg/m(2)/d IV on days 2 to 4. Thirty-eight patients (36 assessable for response) were treated for a median of four cycles. Twenty-nine (81%) of 36 patients had prior hormonal therapy. Study patients had visceral metastases, lytic bone disease, and relatively low serum prostate-specific antigen (PSA). We observed 22 partial responses (response rate, 61% in an intent-to-treat analysis); toxicity was severe (grade 3 or 4 neutropenia 100%, thrombocytopenia 66%, mucositis 21%, and infection 68%). Three patients died of toxicity. Median time to progression and overall survival time were 5.8 months and 10.5 months, respectively. Performance status, serum albumin, and number of organs involved (but not PSA, carcinoembryonic antigen, or neuroendocrine markers) were predictors of survival. SCPCa presents unique clinicopathologic features. Addition of doxorubicin to the etoposide/cisplatin regimen caused higher toxicity in this patient population and failed to improve outcome. Given these results, we do not recommend further development of this regimen for patients with SCPCa. Improvement in therapy will come from understanding the biology of SCPCa progression and integrating new targeted therapies into the treatment of SCPCa.