Multiple Tumor Marker Elevation in Androgen Ablation-Refractory Prostate Cancer with Long-Term Response to Metronomic Chemotherapy: A Case Report

2010 ◽  
Vol 25 (4) ◽  
pp. 243-247 ◽  
Author(s):  
Mariangela Massaccesi ◽  
Franca Forni ◽  
Pasquale Spagnuolo ◽  
Gabriella Macchia ◽  
Samantha Mignogna ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Colon Adenocarcinoma ◽  
Metronomic Chemotherapy ◽  
Serum Levels ◽  
Hormone Refractory Prostate Cancer ◽  
Multiple Tumor ◽  
Androgen Ablation ◽  
Antiangiogenic Therapies ◽  
Specific Tumor ◽  
Hormone Refractory

Outcomes in hormone-refractory prostate cancer are very poor. The time from progression to death is only 12–19 months. We present the case of a 69-year-old man with hormone-refractory prostate cancer and bone metastases treated with metronomic chemotherapy (cyclophosphamide based). He had had a colon adenocarcinoma ten years before. The atypical features of this case were an unusually long-lasting response to metronomic chemotherapy and an increase in serum levels of some non-prostate-specific tumor markers (CEA and CA 19–9) that was not related to a relapse of colon cancer. We hypothesize a potential role of hypoxia inducing CA 19–9 and CEA expression in tumor cells, which may predict the development of progressive resistance to antiangiogenic therapies.

Metronomic chemotherapy for hormone refractory prostate cancer (HRPC)

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 15649-15649
Author(s):  
S. Hoshi ◽  
K. Numahata ◽  
K. Hoshi ◽  
K. Suzuki ◽  
K. Ono ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Lymph Node ◽  
Bone Scan ◽  
Performance Status ◽  
Metronomic Chemotherapy ◽  
Response Duration ◽  
Complete Regression ◽  
Hormone Refractory Prostate Cancer ◽  
Median Response ◽  
Hormone Refractory

15649 Background: Low dose continuous chemotherapy (metronomic chemotherapy) is trying to many advanced cancers. Metronomic chemotherapy has important anti-angiogenic activity to tumor vessels. For patients who progressed after docetaxel, no standard options exist. We have experienced complete regression of bone metastases on super scan by low does cisplatin, UFT, diethylstilbestrol, and dexamethasone (CUDD) in a patient with HRPC (Int JCO, 8,118, 2003). Methods: CUDD consisting of weekly 5 mg/body of cisplatin plus 125 mg/body of diethylstilbestrol and daily 300–450 mg of UFT/day plus 0.5–1 mg of dexamethasone were given to 47 HRPC patients, (median and range of age: 66 and 52–72, respectively). The ECOG performance status was 0 to 1. Gleason score was 7 in 10 patients and 8 in 17 patients and 9 in 20 patients, respectively. Metastatic site was bone in 45 (EOD grade 1:10, 2:18, 3: 15, 4:2), lymph node in 8. Six cases became refractory to docetaxel were treated with CUDD plus CPM (50 mg/day). Results: Among the 45 patients assessable for bone metastasis, 12 (27 %) obtained marked improvement on bone scan. One was EOD grade 4 (super bone scan) and 9 were EOD grade 1–3. Eighteen (40 %) were stable and 15 (33%) progressed on bone scan. Among 8 patients of lymph node metastasis, 3 (38%) showed partial response, 2 (25%) no change and 3 (38%) progression. Twenty-five (53 %) out of 47 patients showed a PSA decline of 50% or greater. Among the 25 patients assessable for bone pain, 7 (28%) improved, 12 (48%) remained stable and 6 (24%) progressed. Their median response duration and median survival time were 8 months (range; 2 to 44 months) and 20 months (range, 4 to 48 months), respectively. Their median response duration was 3 months. Three of 6 refractory to docetaxel were responded to CUDD plus CPM. Their median response duration was 10 months. Conclusions: CUDD is effective in almost half of hormone refractory prostate cancer patients and has advantage of minimal side effect. Three of 6 docetaxel refractory cases also responded to CUDD plus CPM. No significant financial relationships to disclose.

Preliminary results of a phase I study: A chimeric monoclonal anti IL-6 antibody CNTO 328 in combination with docetaxel in patients with hormone refractory prostate cancer

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 15521-15521
Author(s):  
G. R. Hudes ◽  
D. Nanus ◽  
M. Qi ◽  
U. Prabhakar ◽  
R. Corringham ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Phase 1 ◽  
Serum Levels ◽  
Median Number ◽  
High Serum ◽  
Complete Suppression ◽  
Hormone Refractory Prostate Cancer ◽  
Open Label ◽  
Vein Thrombosis ◽  
Hormone Refractory

15521 Background: High serum levels of pro-inflammatory cytokine IL-6 may impact the progression and survival of metastatic hormone refractory prostate cancer (HRPC). CNTO328, an anti IL-6 monoclonal antibody, inhibited prostate tumor growth in several preclinical xenograft mouse models. Methods: This Phase 1, open label study evaluates the safety, pharmacokinetics (PK), and pharmacodynamics of CNTO328 at three dose levels (6mg/kg q2 weeks, 9mg/kg q3 weeks and 12mg/kg q3 weeks) in combination with docetaxel (75mg/m2 q3 weeks) in men with metastatic HPRC. C-reactive protein (CRP), a surrogate biomarker of serum IL-6, and circulating tumor cells (CTC) are evaluated. Results: Eight patients with a median baseline PSA value of 56.8 ng/ml (range 13.6- 436.9 ng/ml) were treated in the first cohort (6 mg/kg CNTO328 q2 weeks in combination with docetaxel 75 mg/m2 q3 weeks). At baseline, 6 patients (75%) had detectable CRP and 6 patients had detectable CTCs. The median number of CNTO328 doses and docetaxel cycles administered was 6 (CNTO328: range 3 to 11 doses; docetaxel: range 3 to 13 cycles). No first-cycle DLT was observed for this combination. Three patients discontinued treatment due to docetaxel-related grade 3 adverse events (deep vein thrombosis, hyperbilirubinemia, and nail changes) after 6, 11, and 13 cycles of docetaxel, respectively. Serum CRP decreased to below detectable levels 7 days after the first dose of CNTO328 in all patients with measurable values at baseline and remained undetectable throughout treatment. Two patients with post-treatment CTC values showed CTC reduction from 82 to1, and 127 to1, respectively. Six of 8 patients had = 50% PSA reductions and all had stable or improved bone scans and/or CT scans. PK of CNTO328 and docetaxel, alone and in combination, will be presented. Conclusions: Thus far, anti-IL6 therapy with CNTO328 at 6mg/kg q2 weeks in combination with docetaxel 75mg/m2 q3 week has been feasible and tolerable. Complete suppression of CRP and PSA reduction provide evidence of biological and anti-tumor activity of this approach and support further testing. [Table: see text]

scholarly journals Heat Shock Protein 27 Increases after Androgen Ablation and Plays a Cytoprotective Role in Hormone-Refractory Prostate Cancer

2004 ◽  
Vol 64 (18) ◽  
pp. 6595-6602 ◽  
Author(s):  
Palma Rocchi ◽  
Alan So ◽  
Satoko Kojima ◽  
Maxim Signaevsky ◽  
Eliana Beraldi ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Heat Shock ◽  
Heat Shock Protein ◽  
Heat Shock Protein 27 ◽  
Hormone Refractory Prostate Cancer ◽  
Androgen Ablation ◽  
Hormone Refractory

Importance of continued testicular suppression in hormone-refractory prostate cancer.

1993 ◽  
Vol 11 (11) ◽  
pp. 2167-2172 ◽  
Author(s):  
C D Taylor ◽  
P Elson ◽  
D L Trump
Keyword(s):  
Prostate Cancer ◽  
Weight Loss ◽  
Performance Status ◽  
Survival Duration ◽  
Hormone Refractory Prostate Cancer ◽  
Androgen Ablation ◽  
Systemic Treatments ◽  
Disease Site ◽  
Androgen Suppression ◽  
Hormone Refractory

PURPOSE Patients in whom prostate cancer progresses despite testicular androgen ablation are generally said to have cancers that have become resistant to hormonal maneuvers. If androgen suppression has been pharmacologic, this therapy is often stopped before consideration of other systemic treatments. This exploratory study sought clinical correlates of experimental evidence that there may be substantial acceleration of tumor growth after cessation of androgen suppression. MATERIALS AND METHODS A retrospective multivariate analysis was performed on survival data for 341 patients treated on four clinical trials of secondary therapy for hormone-refractory prostate cancer. Factors included in the model were recent weight loss, age, performance status, disease site (soft tissue v bone-dominant), prior radiotherapy, and continued androgen suppression v discontinued exogenous endocrine therapy. RESULTS Recent weight loss, age, performance status, and disease site were important prognostic factors for survival duration in hormone-refractory prostate cancer. Correcting for these factors, continued testicular androgen suppression was also an important predictor of survival duration in all data sets examined. CONCLUSION This retrospective study showed a modest advantage in survival duration for men with hormone-refractory prostate cancer who continued to receive testicular androgen suppression. The hypothesis that continued hormonal maneuvers can still affect survival in this group warrants examination in prospective trials.

MP-08.02: Metronomic chemotherapy for hormone refractory prostate cancer (HRPC)

Urology ◽  
2007 ◽  
Vol 70 (3) ◽  
pp. 77-78
Author(s):  
S. Hoshi ◽  
K. Hoshi ◽  
K. Ono ◽  
T. Kobayashi ◽  
M. Sasaki ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Metronomic Chemotherapy ◽  
Hormone Refractory Prostate Cancer ◽  
Hormone Refractory

Hormonal and Chemotherapeutic Systemic Therapy for Metastatic Prostate Cancer

1996 ◽  
Vol 3 (6) ◽  
pp. 493-500 ◽  
Author(s):  
Ravat Panvichian ◽  
Kenneth J. Pienta
Keyword(s):  
Prostate Cancer ◽  
Metastatic Prostate Cancer ◽  
Patient Survival ◽  
Tumor Biology ◽  
The United States ◽  
Hormone Refractory Prostate Cancer ◽  
Ablation Therapy ◽  
Androgen Ablation ◽  
Hormone Refractory ◽  
Androgen Ablation Therapy

Background Prostate cancer is the most frequently diagnosed cancer and the second leading cause of cancer death in men in the United States. It is estimated that over 300,000 men will have been diagnosed with prostate cancer in 1996, and more than 40,000 will have died of this disease. Methods The authors combined their experience with a review of the literature on management of this disease to examine the effectiveness of treatments for both localized and metastatic prostate cancer. Results Surgery and radiation therapy are potentially curative modalities for cancer still limited to the gland. Androgen ablation therapy results in stabilization or regression of metastatic disease in most instances but is not curative. Some new approaches are described for patients with hormone-refractory prostate cancer. Conclusions Newer tumor-biology-based combinations are promising in the treatment of hormone-refractory prostate cancer, but their effect on patient survival needs to be evaluated in larger clinical trials.

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