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Repetitively dosed docetaxel and ¹⁵³samarium-EDTMP as an antitumor strategy for metastatic castration-resistant prostate cancer.
- Source :
-
Cancer [Cancer] 2013 Sep 01; Vol. 119 (17), pp. 3186-94. Date of Electronic Publication: 2013 Jun 13. - Publication Year :
- 2013
-
Abstract
- Background: β-emitting bone-seeking radiopharmaceuticals have historically been administered for pain palliation whereas docetaxel prolongs life in patients with metastatic castration-resistant prostate cancer (mCRPC). In combination, these agents simultaneously target the bone stroma and cancer cell to optimize antitumor effects. The toxicity and efficacy when each agent is combined at full, recommended doses, in a repetitive fashion is not well established.<br />Methods: Patients with progressive mCRPC and ≥ 3 bone lesions received (153) Sm-EDTMP (samarium-153 ethylene diamine tetramethylene phosphonate) at a dose of 1.0 mCi/kg every 9 weeks and docetaxel at a dose of 75 mg/m(2) every 3 weeks. In the absence of unacceptable toxicity, patients were allowed to continue additional cycles, defined by 9 weeks of treatment, until intolerance or biochemical/radiographic disease progression.<br />Results: Of the 30 patients treated, approximately 50% were considered to be taxane-naive, 36.7% were taxane-refractory, and 13.3% had previously been exposed to taxanes but were not considered refractory. Patients received on average 2.5 cycles of treatment (6.5 doses of docetaxel and 2.5 doses of (153) Sm-EDTMP). Twelve patients (40%) demonstrated a decline in their prostate-specific antigen level of ≥ 50%. The median progression-free survival (biochemical or radiographic) was 7.0 months and the overall survival was 14.3 months. Nine patients (30%) did not recover platelet counts >100 K/mm(3) after a median of 3 cycles to allow for additional treatment, with 4 patients experiencing prolonged thrombocytopenia. The most common reasons for trial discontinuation were progressive disease and hematologic toxicity.<br />Conclusions: The results of the current study indicate that (153) Sm-EDTMP can be safely combined with docetaxel at full doses on an ongoing basis in patients with mCRPC. Although thrombocytopenia limited therapy for some patients, preliminary efficacy supports the strategy of combining a radiopharmaceutical with chemotherapy, which is an appealing strategy given the anticipated availability of α emitters that can prolong survival.<br /> (Copyright © 2013 American Cancer Society.)
- Subjects :
- Aged
Aged, 80 and over
Antineoplastic Combined Chemotherapy Protocols adverse effects
Blood Platelets drug effects
Bone Neoplasms radiotherapy
Bone Neoplasms secondary
Disease Progression
Disease-Free Survival
Docetaxel
Hemoglobins drug effects
Humans
Male
Middle Aged
Neoplasm Staging
Neutropenia chemically induced
Orchiectomy
Platelet Count
Prostate-Specific Antigen blood
Prostatic Neoplasms blood
Prostatic Neoplasms diagnosis
Radioisotopes administration & dosage
Severity of Illness Index
Thrombocytopenia chemically induced
Treatment Outcome
Antineoplastic Combined Chemotherapy Protocols administration & dosage
Organometallic Compounds administration & dosage
Organophosphorus Compounds administration & dosage
Prostatic Neoplasms drug therapy
Prostatic Neoplasms pathology
Taxoids administration & dosage
Subjects
Details
- Language :
- English
- ISSN :
- 1097-0142
- Volume :
- 119
- Issue :
- 17
- Database :
- MEDLINE
- Journal :
- Cancer
- Publication Type :
- Academic Journal
- Accession number :
- 23765638
- Full Text :
- https://doi.org/10.1002/cncr.28103