Myers C, Cooper M, Stein C, LaRocca R, Walther M M, Weiss G, Choyke P, Dawson N, Steinberg S, Uhrich M M
Clinical Pharmacology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892.
J Clin Oncol. 1992 Jun;10(6):881-9. doi: 10.1200/JCO.1992.10.6.881.
Suramin is known to inhibit the growth of malignant prostate carcinoma cells in vitro. This led us to evaluate the effectiveness of suramin in the treatment of 38 patients with prostate carcinoma refractory to hormone therapy.
Suramin was administered by continuous infusion at a rate designed to reach a peak of 300 micrograms/mL at the end of 14 days. Patients were given 8 weeks to recover from any toxicity before beginning the second cycle. Subsequent cycles were administered in the same manner except the starting dose rate was 280 mg/m2.
In 17 patients with measurable soft tissue disease, three had complete disappearance of soft tissue disease for 4, 5, and 11 months, whereas three patients had a greater than or equal to 50% decrease in the sum of the products of the diameters of all measurable disease for greater than or equal to 1 month. Of these 17 patients, pretreatment prostate-specific antigen (PSA) decreased by 75% or more in five (29%) and normalized in one (6%). The remaining 21 patients had disease limited to bone, and only one of these experienced resolution of more than 50% of all lesions on bone scan. Of these 21 patients, pretreatment PSA decreased by 75% or more in eight (38%) and normalized in five (25%). Median time to progression for all patients was 26.3 weeks, and median survival was 42.3 weeks. Patients with bone involvement alone exhibited a better survival than patients with soft tissue involvement (P2 = .02). Survival was strongly correlated (P2 = .0001) with a decline in the pretreatment PSA of greater than or equal to 75% by the eighth week on therapy, with nearly an 85% survival at 1 year compared with a 20% survival for those whose pretreatment PSA did not decline by that amount.
We conclude that suramin is an active agent in hormone-refractory prostate carcinoma.
已知苏拉明在体外可抑制恶性前列腺癌细胞的生长。这促使我们评估苏拉明对38例激素治疗难治性前列腺癌患者的治疗效果。
以旨在在14天结束时达到300微克/毫升峰值的速率持续输注苏拉明。患者在开始第二个周期前有8周时间从任何毒性反应中恢复。后续周期以相同方式给药，只是起始剂量率为280毫克/平方米。
在17例有可测量软组织疾病的患者中，3例软组织疾病完全消失达4、5和11个月，而3例患者所有可测量疾病直径乘积之和减少大于或等于50%达大于或等于1个月。在这17例患者中，5例（29%）治疗前前列腺特异性抗原（PSA）下降75%或更多，1例（6%）恢复正常。其余21例患者疾病局限于骨骼，其中只有1例骨扫描显示超过50%的所有病灶消退。在这21例患者中，8例（38%）治疗前PSA下降75%或更多，5例（25%）恢复正常。所有患者的中位进展时间为26.3周，中位生存期为42.3周。单纯骨受累患者的生存期优于软组织受累患者（P2 = 0.02）。生存期与治疗第8周时治疗前PSA下降大于或等于75%密切相关（P2 = 0.0001），1年生存率近85%，而治疗前PSA未下降该幅度的患者生存率为20%。
我们得出结论，苏拉明是激素难治性前列腺癌的一种有效药物。
