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Phase II evaluation of oral estramustine, oral etoposide, and intravenous paclitaxel in patients with hormone-sensitive prostate adenocarcinoma.

Publication ,  Journal Article
Mackler, NJ; Pienta, KJ; Dunn, RL; Cooney, KA; Redman, BG; Olson, KB; Fardig, JE; Smith, DC
Published in: Clin Genitourin Cancer
June 2007

PURPOSE: The primary objective of this study was to assess the feasibility and efficacy of administering etoposide/estramustine/paclitaxel in hormone-sensitive metastatic prostate cancer responding to hormonal therapy. PATIENTS AND METHODS: Eligible patients had metastatic prostate cancer and had received combined androgen blockade for 6-8 months with a > or = 80% decrease in prostate-specific antigen from pretreatment. They received 4 cycles of chemotherapy consisting of estramustine 280 mg orally 3 times daily, etoposide 50 mg/m2 orally on days 1-14, and paclitaxel 135 mg/m2 intravenously for 1 hour on day 2 of each 21-day cycle and were then followed until time to treatment failure (TTF). RESULTS: Twenty-six patients were evaluable for response and toxicity. Median TTF was 21.7 months (range, 11.9-64.5 months; 95% confidence interval, 15.3-26.2 months). Median survival from time of initiation of hormone therapy was 5.1 years. Neutropenia was the most common grade 3/4 toxicity, occurring in 3 patients. Significant toxicities were limited to nausea, diarrhea, and febrile neutropenia in 3 patients, respectively. CONCLUSION: The administration of paclitaxel/estramustine/etoposide in this setting is feasible and well tolerated. Although the TTF of 21.7 months by prostate-specific antigen criteria is similar to historical controls in the emergence of clinically evident androgen-independent disease after starting hormone therapy, direct comparisons cannot be made. More trials are needed to investigate the timing of chemotherapy in patients with prostate cancer.

Duke Scholars

Published In

Clin Genitourin Cancer

DOI

ISSN

1558-7673

Publication Date

June 2007

Volume

5

Issue

5

Start / End Page

318 / 322

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Survival Rate
  • Prostatic Neoplasms
  • Prostate-Specific Antigen
  • Paclitaxel
  • Oncology & Carcinogenesis
  • Neoplasms, Hormone-Dependent
  • Middle Aged
  • Male
  • Injections, Intravenous
 

Citation

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MLA
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Mackler, N. J., Pienta, K. J., Dunn, R. L., Cooney, K. A., Redman, B. G., Olson, K. B., … Smith, D. C. (2007). Phase II evaluation of oral estramustine, oral etoposide, and intravenous paclitaxel in patients with hormone-sensitive prostate adenocarcinoma. Clin Genitourin Cancer, 5(5), 318–322. https://doi.org/10.3816/CGC.2007.n.010
Mackler, Niklas J., Kenneth J. Pienta, Rodney L. Dunn, Kathleen A. Cooney, Bruce G. Redman, Karin B. Olson, Judith E. Fardig, and David C. Smith. “Phase II evaluation of oral estramustine, oral etoposide, and intravenous paclitaxel in patients with hormone-sensitive prostate adenocarcinoma.Clin Genitourin Cancer 5, no. 5 (June 2007): 318–22. https://doi.org/10.3816/CGC.2007.n.010.
Mackler NJ, Pienta KJ, Dunn RL, Cooney KA, Redman BG, Olson KB, et al. Phase II evaluation of oral estramustine, oral etoposide, and intravenous paclitaxel in patients with hormone-sensitive prostate adenocarcinoma. Clin Genitourin Cancer. 2007 Jun;5(5):318–22.
Mackler, Niklas J., et al. “Phase II evaluation of oral estramustine, oral etoposide, and intravenous paclitaxel in patients with hormone-sensitive prostate adenocarcinoma.Clin Genitourin Cancer, vol. 5, no. 5, June 2007, pp. 318–22. Pubmed, doi:10.3816/CGC.2007.n.010.
Mackler NJ, Pienta KJ, Dunn RL, Cooney KA, Redman BG, Olson KB, Fardig JE, Smith DC. Phase II evaluation of oral estramustine, oral etoposide, and intravenous paclitaxel in patients with hormone-sensitive prostate adenocarcinoma. Clin Genitourin Cancer. 2007 Jun;5(5):318–322.
Journal cover image

Published In

Clin Genitourin Cancer

DOI

ISSN

1558-7673

Publication Date

June 2007

Volume

5

Issue

5

Start / End Page

318 / 322

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Survival Rate
  • Prostatic Neoplasms
  • Prostate-Specific Antigen
  • Paclitaxel
  • Oncology & Carcinogenesis
  • Neoplasms, Hormone-Dependent
  • Middle Aged
  • Male
  • Injections, Intravenous