According to an article recently published in the journal Urology, treatment consisting of Taxol® (paclitaxel) and Paraplatin® (carboplatin) provides superior outcomes compared to Novantrone® (mitroxantrone) in the treatment of hormone-refractory prostate cancer.
The prostate is a gland of the male reproductive system. It produces some of the fluid that transports sperm during ejaculation. After skin cancer, prostate cancer is the most common form of cancer diagnosed in men. The outlook for men diagnosed with prostate cancer is good: Overall survival rates for all stages of prostate cancer have improved dramatically over the past 20 years.
Current treatment options for prostate cancer include watchful waiting, surgery, chemotherapy, radiation, or hormonal therapy. Hormonal therapy is designed to block testosterone from stimulating the growth of hormone-dependent types of prostate cancer.
Some prostate cancers become resistant to hormonal therapy and then require a different treatment approach; this condition is known as hormone refractory prostate cancer (HRPC). Chemotherapy is standard treatment for HRPC.
Historically, the chemotherapy agent Novantrone was most commonly used for the treatment of HRPC. More recently, however, Taxotere® (docetaxel)-based regimens have replaced Novantrone as initial chemotherapy regimens in the treatment of HRPC.
Researchers from France recently conducted a clinical trial to compare the chemotherapy combination of Taxol and Paraplatin to Novantrone in the treatment of HRPC. Overall, treatment with Taxol/Paraplatin provided improved outcomes compared to Novantrone:
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- Reductions in prostate-specific antigen (PSA) levels (proteins that measure the presence and/or extent of prostate cancer) occurred in 40% of patients treated with Taxol/Paraplatin compared with only 10% of patients treated with Novantrone.
- Duration of responses was 8.6 months for patients treated with Taxol/Paraplatin, compared with 2 months for those treated with Novantrone.
- Partial disappearances of detectable cancer occurred in 25% of patients treated with Taxol/Paraplatin, compared with no patients treated with Novantrone.
- Medial overall survival was 14.5 months for patients treated with Taxol/Paraplatin, compared with 11.1 months for those treated with Novantrone.
- The major side effect associated with Taxol/Paraplatin was sensory neuropathy (pain, loss of sensation or inability to control muscles).
The researchers concluded that Taxol/Paraplatin appears superior to Novantrone in the treatment of HRPC. Future trials are warranted to compare Taxol/Paraplatin to Taxotere-based regimens for the treatment of this disease.
Patients with HRPC eligible for chemotherapy may wish to speak with their physician regarding their individual risks and benefits of participating in a clinical trial comparing different chemotherapy regimens or evaluating new therapeutic options. Two sources of information regarding ongoing clinical trials include the National Cancer Institute (www.cancer.gov) and www.cancerconsultants.com.
Reference: Cabrespine A, Guy L, Khenifar E, et al. Randomized phase II study comparing paclitaxel and carboplatin versus mitoxantrone in patients with hormone-refractory prostate cancer. *Urology.*2006;67:354-359
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