Docetaxel plus prednisone versus mitoxantrone plus prednisone for metastatic hormone-refractory prostate cancer in chinese patients: Experience of a single center

Purpose: To preliminarily investigate the efficacy of docetaxel plus prednisone and mitoxantrone plus prednisone for treating metastatic hormone-refractory prostate cancer and to further evaluate its adverse events in Chinese patients. Materials and Methods: 83 patients with metastatic hormone-refractory prostate cancer were enrolled in the trial and given a combination of docetaxel 75 mg/m(2) intravenously on day 2 or mitoxantrone 12 mg/m(2) on day 1 plus prednisone 5 mg twice daily on days 1-21, 21 days a cycle. Serum PSA level, relief of bone pain, myelosuppression, and vomiting were recorded and calculated. Results: Docetaxel plus prednisone was administered to 44 patients: 13.6% (6/44) of them achieved complete response, 29.5% ( 13/44) partial response, 29.5% (13/44) had stable disease, and 27.3% (12/44) had disease progression. The average time to PSA progression was 37.8 weeks (12-101 weeks) in the response and stable disease patients. The 12 patients with disease progression were given MP as salvage therapy, and 16.7% (2/12) achieved a partial response, 25.0% (3/12) had stable disease and formed the new baseline. Only 2 patients died of disease aggravation. Mitoxantrone plus prednisone were given to 39 patients, and 7.7% (3/39) of them achieved complete response, 25.6% (10/39) partial response, 25.6% ( 10/39) had a stable disease, and 41.0% (16/39) of patients had disease progression. The mean time to PSA progression was 25.3 weeks (8-61 weeks) in the response and stable disease patients. The 14 patients with disease progression were administered DP as a salvage therapy and 7.1% (1/14) achieved complete response, 35.7% (5/14) partial response, and 21.4% (3/14) had stable disease and formed the new baseline. Four patients had died at the last follow-up. Conclusions: In Chinese patients, docetaxel plus prednisone is better than mitoxantrone plus prednisone in PSA response rate and PSA control, but has a bit more toxicity. When the tumor is resistant to one regimen, the other might still be effective in controlling disease progression. Copyright (c) 2007 S. Karger AG, Basel.