[Continuous subcutaneous infusion of peplomycin for advanced prostatic cancer patients]

Continuous subcutaneous infusion of peplomycin was performed on 17 patients with metastatic prostate carcinoma, 9 of whom were refractory to conventional hormone therapy. Peplomycin was administered 5 mg daily through a newly-developed "microinfusion pump" for 14 consecutive days. This therapy was discontinued in 3 patients at the cumulative dose of 35, 35 and 55 mg. The mean cumulative dose was 84.7 mg. One patient who received 140 mg of peplomycin developed pulmonary fibrosis which was so mild that he recovered soon after the conservative therapy was instituted. There were no other episodes of pulmonary toxicities. Other major toxicities observed were anorexia (47%) and fever (41%). Of 15 patients who were evaluable with the response criteria of NPCP, 4 patients achieved objective partial regression (two for pulmonary metastases, one for bone metastases and the other for supraclavicular lymphnode metastases) and the other 11 patients remained stable. No progression of the disease was noted. Continuous subcutaneous infusion of peplomycin is advantageous over the bolus injection for increasing its anti-tumor activity as well as for decreasing its pneumotoxicity. It can also be performed for out-patients without difficulty. We believe this therapy should be incorporated in the multidisciplinary therapy of prostatic cancer.