Jellvert Asa, Lissbrant Ingela Franck, Edgren Maliha, Ovferholm Elisabeth, Braide Karin, Olvenmark Ann-Marie Ekelund, Kindblom Jon, Albertsson Per, Lennernäs Bo
Department of Oncology, Sahlgrenska University Hospital, S-413 45 Gothenburg;
Exp Ther Med. 2011 Jul;2(4):579-584. doi: 10.3892/etm.2011.272. Epub 2011 May 12.
Prostate cancer (PC) was previously believed to be a chemoresistant disease. In recent years taxane-based chemotherapy has been shown to prolong survival in patients with castration-resistant prostate cancer (CRPC). It remains to be shown, however, which type of chemotherapy provides the most beneficial effect with the least amount of side effects. Seventeen patients with chemonaive CRPC were enrolled in a pilot study evaluating an orally administered chemo-hormonal treatment regimen using a weekly sequential combination called KEES; consisting of ketoconazole in combination with cyclophosphamide or etoposide in combination with estramustine administered on alternate weeks. Prednisone was administered throughout the treatment period. Prostate-specific antigen (PSA) response and acute and chronic toxicities were evaluated. Seventeen patients with CRPC were treated; eleven patients demonstrated a median reduction in PSA of 87% (range 26-99%). Ten (59%) patients responded with a decrease in PSA >50%. Thrombocytopenia and anaemia were the most common side effects. One study fatality was reported, however, it was unclear whether this was treatment related. In conclusion, KEES may be a promising option for patients with CRPC, resulting in a clear reduction in PSA with limited toxicity. Further clinical evaluation of this metronomic chemohormonal combination is underway.
前列腺癌（PC）以前被认为是一种化疗耐药性疾病。近年来，基于紫杉烷的化疗已被证明可延长去势抵抗性前列腺癌（CRPC）患者的生存期。然而，哪种化疗类型能以最少的副作用提供最有益的效果仍有待证明。17例未经化疗的CRPC患者参加了一项试点研究，评估一种口服化疗-激素治疗方案，该方案采用一种名为KEES的每周序贯联合用药；由酮康唑联合环磷酰胺或依托泊苷联合雌莫司汀交替周给药组成。整个治疗期间均给予泼尼松。评估前列腺特异性抗原（PSA）反应以及急性和慢性毒性。17例CRPC患者接受了治疗；11例患者PSA中位数降低了87%（范围26%-99%）。10例（59%）患者PSA下降>50%，有反应。血小板减少症和贫血是最常见的副作用。报告了1例研究死亡病例，然而，尚不清楚这是否与治疗有关。总之，KEES可能是CRPC患者的一个有前景的选择，可使PSA明显降低且毒性有限。这种节拍式化疗-激素联合方案的进一步临床评估正在进行中。
