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Docetaxel in prostate cancer.

¹Urologic Oncology Program, UCSF Comprehensive Cancer Center, 1600 Divisadero St., 3rd Floor, San Francisco, CA 94115, USA. smalle@medicine.ucsf.edu

Anti-Cancer Drugs

|May 9, 2001

Summary

Docetaxel combined with estramustine shows promise for hormone-refractory prostate cancer, with ongoing trials evaluating optimal dosing and potential combination therapies for improved efficacy and tolerability.

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Area of Science:

Oncology
Urology

Background:

Limited experience exists with docetaxel in hormone-refractory prostate cancer (HRPC).
Estramustine combinations have shown activity but carry risks like nausea and blood clots.
Optimal docetaxel scheduling is needed to mitigate neutropenia.

Purpose of the Study:

To evaluate the efficacy and tolerability of docetaxel-based regimens in HRPC.
To explore the potential benefits of combining docetaxel with estramustine.
To identify optimal treatment schedules for docetaxel in HRPC.

Main Methods:

Two Phase II trials investigated docetaxel combined with estramustine.
Ongoing Phase III studies compare docetaxel/estramustine regimens with mitoxantrone/prednisone.
Preliminary data analyzed weekly docetaxel schedules.

Main Results:

Docetaxel-estramustine demonstrated high prostate-specific antigen response rates (69-74%) and objective responses (23-57%).
Weekly docetaxel, with or without limited estramustine, suggests a balance of efficacy and tolerability.
Ongoing Phase III trials are comparing these regimens to established standards of care.

Conclusions:

Docetaxel-estramustine combinations show significant activity in HRPC.
Weekly docetaxel regimens may offer an improved efficacy-tolerability profile.
Future research will focus on optimizing docetaxel-based therapies and exploring novel combinations for HRPC.

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