Hormone refractory advanced prostate cancer treated with estramustine and paclitaxel combination.

BACKGROUND

The objective of the present study was to investigate the effectiveness of weekly paclitaxel administration in combination with oral estramustine in patients with prostate cancer refractory to hormonal manipulation.

PATIENTS AND METHODS

Between 1999 and 2000, 41 patients were included in the study. All patients had disease progression while on treatment with LH-RH and antiandrogens. After being off hormonal therapy for at least 4 weeks, oral estramustine 520 mg twice daily and 60 minutes paclitaxel 60 mg/m2 once weekly, were administered. In total 152 courses were given (median 3.71).

RESULTS

Toxicity was well-tolerated. The most common adverse effect was low-grade (I-II) neurotoxicity. Objective partial responses were observed in 9 (22%) patients; when PSA decrease was included the total number of responders was 25 (61%) patients. Median survival was 17 months (range 4-42+ months).

CONCLUSION

Long-term median and overall survival was achieved in patients with prostate cancer refractory to hormonal treatment, with oral estramustine and weekly paclitaxel administration. Toxicity was acceptable.