Hoosier oncology group randomized phase II study of docetaxel, vinorelbine, and estramustine in combination in hormone-refractory prostate cancer with pharmacogenetic survival analysis

Noah M. Hahn, Sharon Marsh, William Fisher, Robert Langdon, Robin Zon, Mark Browning, Cynthia S. Johnson, Tiffany J. Scott-Horton, Lang Li, Howard L. McLeod, Christopher J. Sweeney

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49 Scopus citations

Abstract

Purpose: To determine the safety and efficacy of two docetaxel doublets in hormone-refractory prostate cancer (HRPC) patients and to examine the prognostic role of polymorphisms in host genes important to docetaxel metabolism and transport. Experimental Design: Sixty-four chemotherapy-naive patients with HRPC were randomized to docetaxel and vinorelbine (D, 20 mg/m2 i.v. days 1 and 8; V, 25 mg/m2 i.v. days 1 and 8) or docetaxel and estramustine phosphate (D, 60-70 mg/m2 i.v. day 1; E, 280 mg oral thrice daily days 1-5) administered q21d. Primary end point was clinically significant toxicity. A pharmacogenetic analysis of host genes was done in patients who received at least one cycle of docetaxel therapy. Results: Grade 3/4 toxicity occurred in 15.6% of DV patients and in 28.6% DE patients. Neither arm exceeded the threshold of clinically significant toxicity. In the DV arm, objective response rate was 33%, prostate-specific antigen response rate was 20%, and median survival was 16.2 months. In the DE arm, objective response rate was 67%, prostate-specific antigen response rate was 43%, and median survival was 19.7 months. Pharmacogenetic analyses showed a significant association between survival beyond 15 months and the ABCG2 421 C>A (Q141K) polymorphism compared with the wild-type (C/C) genotype (66% versus 27%; P = 0.05). Conclusions: DV and DE doublets are active with a tolerable toxicity profile in patients with HRPC; however, efficacy does not seem superior to standard single-agent docetaxel. The ABCG2 421 C>A (Q141K) polymorphism may be an important predictor of response and survival in HRPC patients treated with docetaxel-based chemotherapy.

Original languageEnglish (US)
Pages (from-to)6094-6099
Number of pages6
JournalClinical Cancer Research
Volume12
Issue number20 PART 1
DOIs
StatePublished - Oct 15 2006

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ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Hahn, N. M., Marsh, S., Fisher, W., Langdon, R., Zon, R., Browning, M., Johnson, C. S., Scott-Horton, T. J., Li, L., McLeod, H. L., & Sweeney, C. J. (2006). Hoosier oncology group randomized phase II study of docetaxel, vinorelbine, and estramustine in combination in hormone-refractory prostate cancer with pharmacogenetic survival analysis. Clinical Cancer Research, 12(20 PART 1), 6094-6099. https://doi.org/10.1158/1078-0432.CCR-06-1188