Chemotherapy with mitoxantrone plus prednisone or prednisone alone for symptomatic hormone-resistant prostate cancer: a Canadian randomized trial with palliative end points.

Abstract

Chemotherapy with mitoxantrone and prednisone provides palliation for some patients with symptomatic hormone-resistant prostate cancer.

Mitoxantrone, vinorelbine and prednisone (MVD) in the treatment of metastatic hormonoresistant prostate cancer — a phase II trial

“…After several reports had established the activity of mitoxantrone in HRPC, Tannock et al 9 and Kantoff et al 10 demonstrated in 1996 that the combination of mitoxantrone and prednisone or hydrocortisone more reliably achieved a palliative response and for a longer duration than glucocorticoids alone. The activity of vinorelbine in HRPC has been shown in phase II trials, in terms of tumour response, PSA decline and clinical benefit criteria.…”

“…9,10 Recently, advances have been made in understanding the biology of hormone-refractory prostate carcinoma, which is elucidating potential targets for new drugs. 11 Vinorelbine is a new semisynthetic vinca-alkaloid derivative with antimicrotubular activity that has shown to be highly effective in small-cell lung cancer compared with vinblastine and vindesine 12,13 and in hormonedependent tumours such as breast cancer.…”

Advanced prostate cancer

“…Recent data from the Canadian group 39 and from the Cancer and Leukemia Group B (CALGB) 40 suggest an average survival of 11 months for this group of patients. Trials of megace 41 and liarazole 42 also suggest median survivals between 11 and 12 months for HRPC patients.…”

“…The Canadian phase III trial 39 showed reduction in pain or analgesics used in 38% of patients on mitoxan- trone and prednisone vs 21% in the group receiving prednisone alone. There was no statistically signi®cant survival difference between the groups.…”

Chlorambucil and lomustine (CL56) in absolute hormone refractory prostate cancer: re-induction of endocrine sensitivity an unexpected finding

“…Following the publication of three phase III studies comparing mitoxantrone and prednisone to prednisone alone in androgen independent prostate cancer, which demonstrated an improvement in symptom control despite failure to improve survival, chemotherapy has become accepted as having a role at this point in the disease (Tannock et al, 1996). More recently, the presentation of two large randomised phase III trials comparing mitoxantrone and docetaxel showed a significant survival advantage in favour of docetaxel (Eisenberger et al, 2004;Petrylak et al, 2004).…”