Annals of Oncology 14:1291-1298, 2003
© 2003 European Society for Medical Oncology
Original Paper |
Phase II study of oxaliplatin versus oxaliplatin combined with infusional 5-fluorouracil in hormone refractory metastatic prostate cancer patients
1 Leon Berard, Lyon; 2 Centre Hospitalier Universitaire (CHU) La Timone, Marseille; 3 CHU G. Doumergue, Nimes; 4 CHU Bicêtre, Le Kremlin Bicêtre; 5 Clinique Hartman, Neuilly; 6 Clinique Pasteur, Evreux; 7 Centre Régionale de Lutte Contre le Cancer Val dAurelle, Montpellier; 8 CHU Bichat, Paris; 9 CHU Paul Brousse, Villejuif; 10 Cvitkovic et Associés Consultants, Le Kremlin-Bicêtre, France
Received 20 September 2002; revised 4 April 2003; accepted 15 April 2003
Background:
A randomized, multicenter phase II study evaluating oxaliplatin alone (OXA) and oxaliplatin5-fluorouracil combination (OXFU) in advanced hormone-refractory prostate cancer (HRPC) patients.
Patients and methods:
Metastatic, pathologically proven prostate carcinoma patients, progressing despite anti-androgen therapy, received intravenous OXA (130 mg/m2 over 2 h), alone or with 5-FU (1000 mg/m2/day, continuous intravenous infusion, days 14), every 3 weeks. OXA patients could receive OXFU after treatment failure.
Results:
Fifty-four patients (26 OXA, 28 OXFU) from nine centers received 269 treatment cycles (106 OXA, 163 OXFU; median 3.5 OXA or 5 OXFU cycles per patient; range 110 or 114, respectively). Patient characteristics were similar in both arms. Three partial responses (PR) occurred in 21 evaluable OXA patients [14%; 95% confidence interval (CI) 1% to 30%], and in five of 26 evaluable OXFU patients (19%; 95% CI 7% to 39%). Clinical benefit response (pain, performance status and weight changes) was assessed in 20 OXA and 22 OXFU symptomatic patients, with more responders in the OXFU arm (39% compared with 12%). Median time to progression in the OXA and OXFU arms was 2.6 and 3.4 months, and median overall survival was 9.4 and 11.4 months, respectively. Hematotoxicity was common, but mostly mild to moderate. Neutropenia was more common in OXFU than OXA patients. After oxaliplatin failure, 12 patients received 46 cycles of OXFU and one of 11 evaluable patients had a PR.
Conclusion:
The objective response rate, palliation benefit, survival and manageable toxicity obtained in this heavily pretreated HRPC population with OXFU merit further study.
Key words: DACH-platinum, 5-fluorouracil, HRPC, oxaliplatin