Results of a phase II study with doxorubicin, etoposide, and cisplatin in patients with fully characterized small-cell carcinoma of the prostate
Results of a phase II study with doxorubicin, etoposide, and cisplatin in patients with fully characterized small-cell carcinoma of the prostate
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DOI：
10.1200/jco.2002.12.065
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发表时间：
2002-07-15
影响因子：
45.3
通讯作者：
Logothetis, CJ
中科院分区：
文献类型：
--
作者：
Papandreou, CN;Daliani, DD;Logothetis, CJ
目的：确定阿霉素联合顺铂和依托泊苷治疗小细胞前列腺癌（SCPCa）患者的活性和毒性，并描述SCPCa的临床病理特征。SCPC患者a（纯的或混合的），可测量的疾病，良好的器官功能，并且没有用阿霉素，依托泊苷，阿霉素50 mg/m2静脉滴注24 h，每4周1次，依托泊苷120 mg/m2/d，顺铂25 mg/m2/d，第24天静脉滴注。38例患者（36例可评估缓解）接受了中位4个周期的治疗。36例患者中有29例（81%）既往接受过激素治疗。研究患者有内脏转移、溶骨性疾病和相对较低的血清前列腺特异性抗原（PSA）。我们观察到22例部分缓解（意向治疗分析中的缓解率为61%）;毒性严重（3级或4级中性粒细胞减少100%，血小板减少66%，粘膜炎21%，感染68%）。3例患者死于毒性。中位进展时间和总生存时间分别为5.8个月和10.5个月。性能状态，血清白蛋白，和涉及的器官（但不是PSA，癌胚抗原，或神经内分泌标志物）的数量是survival.Conclusion：SCPCa提出了独特的临床病理特征的预测。在该患者人群中，在etaposide/顺铂方案中添加多柔比星导致更高的毒性，并且未能改善结局。鉴于这些结果，我们不建议进一步开发SCPCa患者的该方案。治疗的改进将来自于理解SCPCa进展的生物学和将新的靶向治疗整合到SCPCa的治疗中。(C)2002年，美国临床肿瘤学会。
Purpose: 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 and Methods: 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.Results: 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.Conclusion: SCPCa presents unique clinicopathologic features. Addition of doxorubicin to the etaposide/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. (C) 2002 by American Society of Clinical Oncology.