Combination chemotherapy with estramustine phosphate, ifosfamide and cis-platin in hormone-refractory prostate cancer

To date, there has been no effective therapy against hormone-refractory prostate cancer (HRPC). This led us to evaluate the efficiency and toxicity of estramustine phosphate (ECT), ifosfamide (IFM) and Cis-platin (CDDP) combination chemotherapy in patients with HRPC. ECT at a daily dose of 560mg was given intravenously in combination with IFM, 1.2 g/m², on days 1 to 5, and CDDP, 70 mg/ m², on day 1. This combination therapy was given every 3 to 4 weeks. Twenty-one patients with HRPC were enrolled in this trial. An objective response of more than 50% reduction in prostate -specific antigen was observed in nine out of eighteen patients (50%), and more than 50% reduction in bidimensionally measurable soft-tissue lesions was observed in two out of seven patients (29%). The median response duration of overall partial response cases was 40 weeks, while the median response duration of overall partial response plus stable cases was 30 weeks. The median survival duration of all cases was 47 weeks. Toxicity was modest and acceptable; nausea/vomiting (67%), alopecia (48%), anemia (76%), leukocytopenia (57%), thrombocytopenia (48%), renal dysfunction (24%) and liver dysfunction (19%) were noticed. Severe toxicity was observed in two cases, one case with myocardial infarction and one case with deep vein thrombosis. We conclude that the ECT, IFM and CDDP combination chemotherapy regimen can be highly recommended for the treatment of HRPC.