Transitional Cell Carcinoma of the Prostate: Response to Treatment with Cisplatinum and Cyclophosphamide

Alexander, Saramma J.; Lee, Steve S.; Bekhrad, Abbas

doi:10.1016/s0022-5347(17)50736-3

Cited by 14 publications

(1 citation statement)

References 8 publications

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“…Urothelial (transitional cell) carcinoma of the prostate, which probably constitutes 1-5% of all prostatic carcinomas (7,9,12,18), responds poorly to oestrogen therapy (3,12), since it arises from the prostatic duct or the epithelium lining the prostatic urethra (4,7,16). The cell origin of de novo squamous cell carcinoma of the prostate, like that of the adenosquamous tumours, is unclear, though it was earlier maintained to be the transitional epithelium lining the urethra or major duct (8,17).…”

Section: Discussionmentioning

confidence: 99%

Mixed Prostatic Carcinoma Containing Malignant Squamous Element

Ishigooka

Yaguchi

Tomaru

et al. 1994

Scandinavian Journal of Urology and Nephrology

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Section: Discussionmentioning

confidence: 99%

Mixed Prostatic Carcinoma Containing Malignant Squamous Element

Ishigooka

Yaguchi

Tomaru

et al. 1994

Scandinavian Journal of Urology and Nephrology

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Chemotherapy of urothelial tract tumors

Yagoda

1987

Cancer

136

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Recent data from Phase I1 trials in patients with advanced transitional cell carcinoma of the urothelial tract suggest combination chemotherapy regimens are inducing a higher number of complete remissions (CR), and an overall response rate between 50% and 70%. Most active combination regimens are cisplatin + methotrexate based or cisplatin + Adriamycin (doxorubicin) based. As single agents, cisplatin has a response rate of 30% in 320 patients, methotrexate, 29% in 236 cases, and Adriamycin, 17% in 248 cases. With each drug used singly, however, complete response is uncommon. Other active single agents include vinblastine (16% in 38 cases) and mitomycin C (13% in 42 cases). New agents being evaluated which show some promise include gallium nitrate, carboplatinum, and other antifols. In a trial by the Northern California Oncology Group which evaluated a combination of cisplatin, methotrexate, and vinblastine (CMV), 28% of 50 cases achieved a CR lasting 44 weeks, and 28% a partial remission (PR) sustained for 29 weeks. A limited number of cases required surgical debulking for obtainment of CR status. At the University of Michigan, a trial of cisplatin and dichloromethotrexate induced responses in over 60% of cases. The regimen of methotrexate, vinblastine, Adriamycin, and cisplatin (M-VAC) has been reported to induce CR in 37% of cases, and PR in an additional 31%. In the latter trial at Memorial Hospital in over 100 cases with bidimensionally measurable advanced disease, the median survival of CR has not yet been reached at 28 months, whereas those who achieve PR survive 12 months versus 6 months for nonresponders. Indirectly, the success of such combination regimens is apparent from the increasing number of central nervous system relapses, without systemic recurrence, in complete responders. Additional data indicate that cisplatin + methotrexate, without the addition of other drugs, is also an active regimen. The attainment of CR in 20% to 40% of cases given these multidrug regimens has led to adjuvant and neoadjuvant protocols. Although results of randomized prospective trials have not yet been reported, preliminary Phase I1 data are promising. there has been significant progress in therapy for advanced urothelial tract tumors, so much so, that adjuvant and neoadjuvant trials have now been initiated. ' Of the over 40,000 new cases of urothelial tract tumors annually in the US, including renal pelvis, ureter, urinary bladder, urethra, and prostatic ducts, 20% of patients present with muscle infiltrating (T2-4) lesions and 5% with metastatic (N+, MS) disease.2 In the past, patients with metastatic disease who progress on chemo-

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