Prostate Cancer Scientific Abstracts - A. Cabrespine

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Selected A. Cabrespine prostate cancer abstracts

Journal: The Journal of Urology

Pubmed ID: 16515996

Authors: Cabrespine A, Guy L, Gachon F, Cure H, Chollet P, Bay JO.

Title: LAPSER1: a novel candidate tumor suppressor gene from 10q24.3.

PURPOSE: Neuroendocrine differentiation is a frequent pattern in prostate adenocarcinoma. CgA seems to be a useful indicator of neuroendocrine differentiation in patients with HRPC. We evaluated the clinical interest of circulating CgA in HRPC.

MATERIALS AND METHODS: Serum CgA was assessed by immunoradiometric assay in 39 patients with HRPC treated with paclitaxel and carboplatin or mitoxantrone. Baseline CgA and its variation during chemotherapy were studied.

RESULTS: Increased serum CgA was observed in 45% of patients. Previous local radiotherapy and the duration of hormonal therapy were independent factors that influenced CgA. There was no correlation between CgA and prostate specific antigen. Increased serum CgA showed positive predictive significance but no prognostic value. The chemotherapy response correlated with a CgA decrease of greater than 25%.

CONCLUSIONS: The current study suggests that CgA assessment facilitates patient selection by predicting the chemotherapy response and providing complementary information to follow the chemotherapy response.

Contact: Centre Jean Perrin, Clermont-Ferrand, France; UMR484 INSERM, Clermont-Ferrand, France.

Journal: Urology

Pubmed ID: 11464283

Authors: Cabrespine A, Guy L, Khenifar E, Cure H, Fleury J, Penault-Llorca F, Kwiatkowski F, Barthomeuf C, Chollet P, Bay JO.

Title: Randomized Phase II study comparing paclitaxel and carboplatin versus mitoxantrone in patients with hormone-refractory prostate cancer.

OBJECTIVES: Mitoxantrone/prednisone was the 2002 palliative reference treatment for hormone-refractory prostate cancer (HRPC). Paclitaxel and carboplatin has demonstrated antitumor activity in HRPC. The therapeutic benefit of such treatment was compared with that of mitoxantrone.

METHODS: A randomized Phase II study was conducted that included 40 patients with HRPC who had not undergone chemotherapy. Patients in arm A received paclitaxel (175 mg/m2 every 3-week cycle) and carboplatin (area under the curve of 5 every 3-week cycle). Patients in arm B received mitoxantrone (12 mg/m2 every 3-week cycle). All the patients treated were receiving low-dose prednisone. The primary endpoint was the prostate-specific antigen response.

RESULTS: The prostate-specific antigen response to paclitaxel and carboplatin was significantly greater (40% [95% confidence interval 18.5% to 61.5%] versus 10% [95% confidence interval 1% to 32%], P = 0.031) and more durable (8.6 versus 2 months, P = 0.015) than the response to mitoxantrone. A tendency was noted for patients with measurable disease who were receiving paclitaxel and carboplatin to have a somewhat greater objective response rate than those who received mitoxantrone (23% [95% confidence interval 5.3% to 55%] versus no objective response, P = 0.060). The median overall survival was 14.5 months for the paclitaxel and carboplatin arm compared with 11.1 months for the mitoxantrone arm. The group given paclitaxel and carboplatin had significantly greater rates of sensitive neuropathy (50% versus 0%, P = 0.00026).

CONCLUSIONS: The 3-week regimen of paclitaxel and carboplatin induced a greater and more durable prostate-specific antigen response than did mitoxantrone for HRPC treatment. The major additive toxicity induced was peripheral neuropathy due to paclitaxel. Investigations with paclitaxel and carboplatin regimens merit large Phase III studies.

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