GENITOURINARY : PROSTATE  CANCER

 

Regimen/Number

Of Patients

Drug Dose and Route

Leukopenia/

Neutropenia

Toxicity

Anemia

Toxicity

Other

Grade III-IV Toxicities

Emetogenic

Potential

Consequences of

Adverse Event(s)

Docetaxel-Estramustine

(Sinibaldi VJ, et al.

Cancer.

2002;94:1457-65)

 

N = 40

 

 

Estramustine 280 mg PO every 6 hours for

5 doses; first dose 12 hours befor:

Docetaxel 70 mg/m2 IV over 1 hour

on day 1

Repeat cycle every 21 days

Appropriate premedications listed in Section 2,

Commonly Used Premedication Regimens

Neutropenia

Grade III 30%

Grade IV 45%

 

Grade III 2.5%

 

Febrile Neutropenia

(Grade IV) 5%

fatigue (Grade III) 70%

Diarrhea (Grade III) 7.5%

Hyperglycemia (Grade III) 10%

Local Skin Reaction

(Grade III) 7.5%

Nail Changes

(Grade III) 7.5%

CHF (Grade IV) 2.5%

level 2

 

Docetaxel

Estramustine

Low-Dose

Hydrocortisone

(Savarese DM, et al.

J Clin Oncol.

2001;19:2509-16)

 

N = 46

Estramustine 10 mg/kg/d PO (3 divided

doses) days 1-5 on an empty stomach

Docetaxel 70 mg/m2 IVover 1 hour day 2

Hydrocortisone 30 mg PO every morning and

mg every evening continuously

Repeat estramustine/docetaxel cycles

Every 21 day

 

Notes:

Standard premedications  administered.

Study did not routinely administer

antithrombotic prophylaxis.

Leukopenia

Grade III 57%

Grade IV 4%

Neutropenia

Grade III 26%

Grade IV 30%

Grade III 13%

Infection (site unknown) 24%

Thrombocytopenia 20%

Hyperglycemia 18%

Hypocalcemia (Grade III) 2%

Phlebitis/Thrombosis 6%

Edema 22%

Malaise/Fatigue/Asthenia 24%

Stomatitis/Esophagitis

(Grade III) 6%

Nausea (Grade III) 4%

Vomiting (Grade  IV) 2%

Diarrhea 6%

Anorexia 4%

Hepatic 22%

Dyspnea 22%

Dysrhythmias(Grade III) 2%

Ischemia (Grade III) 7%

BUN/SCr (Grade III) 9%

Renal Failure (Grade IV) 2%

Neurologic (Grade III) 8%

Days 1-5―

level 2

No episodes efebrile neutropenia

Docetaxel dose reduction

required in 6 patients:

2 = Transaminase elevation

1 = Thrombocytopenia

1 = Diarrhea

1 = Dysphagia/

mucositis

1 = Lethargy

paresthesias

Duration of neutropenia

short (< 1 week)

Docetaxel discontinued

in 2 patients:

1 = Acute

hypertension during infusion

24% of patients withdrew

from study due to

low-grade toxicities

(fatigue/asthenia)

 

 

GENITOURINARY  : PROSTATE  CANCER (continued ) : Page 2

 

Regimen/Number

Of Patients

Drug Dose and Route

Leukopenia/

Neutropenia

Toxicity

Anemia

Toxicity

Other

Grade III-IV Toxicities

Emetogenic

Potential

Consequences of

Adverse Event(s)

Estramustine

Vinblastine

(Hudes G, et al.

J Clin Oncol.

1999;17:3160-66)

 

N = 95

 

 

Estramustine 200 mg/m2 PO tid days 1-42

Vinblastine 4 mg/m2 IV weekly for 6 weeks,

begin day 1

Repeat cycle every 8 weeks

Grade III 7%

Grade IV 1%

 

Neutropenic Infection 7%

Thrombocytopenia* 1%

Nausea* 28%

Leg Edema* 12%

Fatigue* 16%

Neurologic* 12%

Constipation* 3%

Cardiac* 5%

 

*Grade II-IV toxicity

Day 1-42―

level  2

Dose reduced in

30% of patients

Mitoxantrone

Prednisone

(Tannock IF, et al.

J Clin Oncol.

1996;14:1756-64)

 

N = 80

Mitoxantrone 12 mg/m2 IV day 1

Prednisone 5 mg PO bid continuously

Repeat cycle every 2  1 days

Neutropenia

Grade III 32%

Grade IV 13%

 

Neutropenic Sepsis 1%

Thrombocytopenia 5%

Nausea/Vomiting <1%

Day 1―

level 3

Dose reduced in

25% of patients,

and increased in

45% of patients

5 patients developed

cardiac abnormalities,

2 symptomatic

with CHF