Abstract
Purpose: Synergy is observed with the combination of capecitabine and docetaxel due to docetaxel mediated up-regulation of thymidine phosphorylase. A phase II trial was performed with the combination for metastatic, castrate resistant prostate cancer. Materials and Methods: Eligible patients had metastatic, castrate resistant prostate cancer, no prior chemotherapy for metastatic disease and normal organ function. Docetaxel (36 mg/m2 per week intravenously) on days 1, 8 and 15, and capecitabine (1,250 mg/m2 per day in 2 divided doses) on days 5 to 18 were administered in 28-day cycles. The response was assessed every 2 cycles. Biomarker correlative studies were performed on blood dihydropyrimidine dehydrogenase, and the thymidine phosphorylase-to-dihydropyrimidine dehydrogenase and thymidine synthase-to-dihydropyrimidine dehydrogenase ratios in available prostate tumor tissue. Results: A total of 30 patients with a median age of 69 years were enrolled in the study. We noted bone pain in 21 patients (70%), Gleason score 8 or higher in 18 (60%), measurable disease progression in 9, bone scan progression in 18 and prostate specific antigen progression in 22. Grade 3 or 4 neutropenia was seen in 3 patients and grade 3 hand-foot syndrome was found in 2. No treatment related deaths occurred. A prostate specific antigen response of 50% or greater decrease was observed in 22 patients (73%), of whom 9 (30%) had 90% or greater decrease. A partial response was noted in 5 of 9 patients (56%) with measurable disease. Median time to progression was 6.7 months (90% CI 4.2-7.7) and median overall survival was 22.0 months (90% CI 18.4-25.3). Conclusions: The combination was well tolerated and it demonstrated favorable response rates with durable remission and survival outcomes.
Original language | English (US) |
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Pages (from-to) | 317-323 |
Number of pages | 7 |
Journal | Journal of Urology |
Volume | 182 |
Issue number | 1 |
DOIs | |
State | Published - Jul 2009 |
Externally published | Yes |
Keywords
- capecitabine
- docetaxel
- neoplasm metastasis
- prostate
- prostatic neoplasms
ASJC Scopus subject areas
- Urology