Weekly docetaxel as second line treatment after mitozantrone for androgen‐independent prostate cancer

Abstract

BACKGROUND: Two recent phase III trials have shown an improvement in survival with the use of docetaxel in metastatic androgen-independent prostate cancer (AIPC) compared to mitozantrone. However no phase II trials have clearly defined the level of activity of docetaxel after mitozantrone. AIMS: We sought to define the activity and toxicity of weekly docetaxel as second line chemotherapy after mitozantrone in men with AIPC. METHODS: Twenty men were treated with docetaxel 40 mg/m2 weekly for 3 of every 4 weeks until progression or prohibitive toxicity. End-points included prostate specific antigen response, common toxicity criteria, time to progression and overall survival. RESULTS: Nine patients (45%) had a 50% or greater reduction in PSA maintained for at least 1 month. Weekly docetaxel was well tolerated with few major toxicities: two patients had Grade 3 diarrhoea (10%) and six had grade 2-4 haematologic toxicities (30%). The median time to progression was 5 months (range 0-13) and median survival was 13 months (range 1-24) from starting docetaxel. The median survival from starting mitozantrone was 19 months. Men who had responded to mitozantrone were no more likely to respond to docetaxel (P = 0.2 Fischer's exact test). CONCLUSIONS: Weekly docetaxel is a safe and active second-line treatment after mitozantrone for androgen-resistant prostate cancer, with similar levels of activity to the first-line setting.