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Journal of Peking University (Health Sciences) ›› 2021, Vol. 53 ›› Issue (4): 686-691. doi: 10.19723/j.issn.1671-167X.2021.04.011

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Clinical efficacy of docetaxel combined with carboplatin in patients with metastatic castration-resistant prostate cancer

BAI Gao-chen,SONG Yi(),JIN Jie(),YU Wei,HE Zhi-song   

  1. National Urological Cancer Center, Beijing 100034, China
  • Received:2021-03-03 Online:2021-08-18 Published:2021-08-25
  • Contact: Yi SONG,Jie JIN E-mail:ddsongyi@263.net;jinjie@vip.163.com

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Abstract:

Objective: To observe the early efficacy and toxicity of docetaxel combined with carboplatin in patients with metastatic castration-resistant prostate cancer (mCRPC). Methods: From May 2017 to July 2019, fifteen patients with mCRPC treated in Peking University First Hospital were collected. The median age was 70 years (43-77 years), and the pathological types were all adenocarcinoma, which was confirmed as distant metastasis by imaging examination. They were given the chemotherapy of docetaxel combined with carboplatin. The specific method was as follows: each cycle was 28 days. Androgen deprivation therapy was administered routinely throughout the treatment period. Blood routine, liver and kidney function, blood clotting function and prostate-specific antigen (PSA) tests were performed before each cycle. Docetaxel was administered intravenously on the first day of each cycle at a dose of 75 mg/m2, and carboplatin was administered intravenously on the second day at the dose calculated by Calvert formula. The main outcome measures including PSA decline range, pain remission rate and occurrence of adverse reactions were observed and analyzed. Results: Among the 15 patients, 12 had completed at least 4 cycles of chemotherapy and had short-term efficacy evaluation. PSA decline range>50% was observed in 8 patients (66.7%). Among the 9 patients with bone pain, remarkable pain relief was observed in 4 patients (44.4%). Among the 4 patients with measurable metastatic lesions, 2 achieved partial response, 1 was evaluated as stable disease, and 1 was evaluated as progressive disease. The main adverse reactions of chemotherapy included bone marrow suppression, gastrointestinal reactions, fatigue and neurological disorders, and most of them were within the tolerable range. Conclusion: This report is a case series study of docetaxel combined with carboplatin in the treatment of mCRPC reported in China and the conclusions are representative. The chemotherapy of docetaxel combined with carboplatin has positive short-term efficacy and high safety in patients with mCRPC, which is worthy of further promotion and exploration in clinical practice.

Key words: Docetaxel, Carboplatin, Prostate cancer

CLC Number: 

  • R697+.3

Table 1

Clinical characteristics of 15 patients with mCRPC"

Characteristics n
Age/years
≤70 8
>70 7
Primary tumor (T stage)
T1-T2 2
T3-T4 13
Regional lymph node (N stage)
N0 1
N1 14
Distant metastasis (M stage)
M0 0
M1a 1
M1b 13
M1c 1
Gleason score
≤8 7
>8 8
PSA level before treatment/(mg/L)
≤20 5
>20 10
NRS for bone pain/(point)
No pain (0) 3
Mild pain (1-3) 1
Moderate pain (4-6) 7
Severe pain (7-10) 4
Treatment phase for mCRPC
First-line 4
Second-line 7
Third-line 4
Fourth-line or more 0

Figure 1

PSA changes in 12 patients with mCRPC who completed at least 4 cycles of chemotherapy A, PSA changes from baseline after 4 cycles of chemotherapy in patients at different treatment phases; B, PSA changes from baseline after 4 cycles of chemotherapy in all patients. PSA, prostate-specific antigen; mCRPC, metastatic castration-resistant prostate cancer."

Table 2

Short-term outcomes in 12 patients with mCRPC who completed at least 4 cycles of chemotherapy"

Items n (%)
PSA decline in 12 evaluable patients
>50% 8(66.6)
0%-50% 1(8.3)
<0% 3(25.0)
Pain response in 9 patients with ostalgia
Decreased 4(44.4)
Stable 4(44.4)
Increased 1(11.1)
RECIST assessment in 4 patients with measurable metastatic lesions
Complete response 0(0)
Partial response 2(50.0)
Stable disease 1(25.0)
Progressive disease 1(25.0)

Table 3

Occurrence of treatment-related adverse reactions in 15 patients with mCRPC [n (%)]"

Adverse reactions Total Grade 1 Grade 2 Grade 3 Grade 4
Leukopenia 6(40.0) 4(26.7) 2(13.3) 0(0) 0(0)
Anemia 6(40.0) 2(13.3) 2(13.3) 2(13.3) 0(0)
Thrombocytopenia 1(6.7) 1(6.7) 0(0) 0(0) 0(0)
Liver function damage 1(6.7) 1(6.7) 0(0) 0(0) 0(0)
Gastrointestinal hemorrhage 1(6.7) 0(0) 1(6.7) 0(0) 0(0)
Nausea/vomiting 3(20.0) 2(13.3) 1(6.7) 0(0) 0(0)
Diarrhea 1(6.7) 1(6.7) 0(0) 0(0) 0(0)
Constipation 1(6.7) 1(6.7) 0(0) 0(0) 0(0)
Fatigue 2(13.3) 1(6.7) 1(6.7) 0(0) 0(0)
Neurological disorders 2(13.3) 2(13.3) 0(0) 0(0) 0(0)
Pigmentation 1(6.7) 1(6.7) 1(6.7) 0(0) 0(0)
Severe infections 1(6.7) 0(0) 0(0) 0(0) 1(6.7)
[1] Siegel RL, Miller KD, Jemal A. Cancer statistics, 2020 [J]. CA Cancer J Clin, 2020, 70(1):7-30.
doi: 10.3322/caac.v70.1
[2] Wu C, Li M, Meng H, et al. Analysis of status and counter-measures of cancer incidence and mortality in China [J]. Sci China Life Sci, 2019, 62(5):640-647.
doi: 10.1007/s11427-018-9461-5
[3] Lowrance WT, Murad MH, Oh WK, et al. Castration-resistant prostate cancer: AUA guideline amendment 2018 [J]. J Urol, 2018, 200(6):1264-1272.
doi: S0022-5347(18)43671-3 pmid: 30086276
[4] 中国抗癌协会泌尿男生殖系肿瘤专业委员会. 2018版转移性前列腺癌诊治中国专家共识 [J]. 中华外科杂志, 2018, 56(9):646-652.
[5] Corn PG, Tu SM, Zurita AJ, et al. A multi-institutional ran-domized phase Ⅱ study (NCT01505868) of cabazitaxel (CAB) plus or minus carboplatin (CARB) in men with metastatic castration-resistant prostate cancer (mCRPC) [J]. J Clin Oncol, 2015, 33(Suppl 15):5010.
doi: 10.1200/jco.2015.33.15_suppl.5010
[6] Aparicio AM, Harzstark AL, Corn PG, et al. Platinum-based chemotherapy for variant castrate-resistant prostate cancer [J]. Clin Cancer Res, 2013, 19(13):3621-3630.
doi: 10.1158/1078-0432.CCR-12-3791
[7] Leal F, García-Perdomo HA. Effectiveness of platinum-based chemotherapy in patients with metastatic prostate cancer: systema-tic review and meta-analysis [J]. Clin Genitourin Cancer, 2019, 17(3):e627-e644.
doi: 10.1016/j.clgc.2019.03.008
[8] Kantoff PW, Halabi S, Conaway M, et al. Hydrocortisone with or without mitoxantrone in men with hormone-refractory prostate can-cer: results of the cancer and leukemia group B 9182 study [J]. J Clin Oncol, 1999, 17(8):2506-2513.
pmid: 10561316
[9] Tannock IF, Osoba D, Stockler MR, et al. Chemotherapy with mitoxantrone plus prednisone or prednisone alone for symptomatic hormone-resistant prostate cancer: a Canadian randomized trial with palliative end points [J]. J Clin Oncol, 1996, 14(6):1756-1764.
pmid: 8656243
[10] Tannock IF, de Wit R, Berry WR, et al. Docetaxel plus prednisone or mitoxantrone plus prednisone for advanced prostate cancer [J]. N Engl J Med, 2004, 351(15):1502-1512.
doi: 10.1056/NEJMoa040720
[11] Petrylak DP, Tangen CM, Hussain MH, et al. Docetaxel and estramustine compared with mitoxantrone and prednisone for advanced refractory prostate cancer [J]. N Engl J Med, 2004, 351(15):1513-1520.
doi: 10.1056/NEJMoa041318
[12] Sweeney CJ, Chen YH, Carducci M, et al. Chemohormonal therapy in metastatic hormone-sensitive prostate cancer [J]. N Engl J Med, 2015, 373(8):737-746.
doi: 10.1056/NEJMoa1503747
[13] James ND, Sydes MR, Clarke NW, et al. Addition of docetaxel, zoledronic acid, or both to first-line long-term hormone therapy in prostate cancer (STAMPEDE): survival results from an adaptive, multiarm, multistage, platform randomised controlled trial [J]. Lancet, 2016, 387(10024):1163-1177.
doi: 10.1016/S0140-6736(15)01037-5
[14] Oh WK, Tay MH, Huang J. Is there a role for platinum chemotherapy in the treatment of patients with hormone-refractory prostate cancer? [J]. Cancer, 2007, 109(3):477-486.
doi: 10.1002/(ISSN)1097-0142
[15] Hager S, Ackermann CJ, Joerger M, et al. Anti-tumour activity of platinum compounds in advanced prostate cancer-a systematic literature review [J]. Ann Oncol, 2016, 27(6):975-984.
doi: S0923-7534(19)35660-1 pmid: 27052650
[16] Huan SD, Stewart DJ, Aitken SE, et al. Combination of epirubicin and cisplatin in hormone-refractory metastatic prostate cancer [J]. Am J Clin Oncol, 1999, 22(5):471-474.
doi: 10.1097/00000421-199910000-00010
[17] Kaku H, Saika T, Tsushima T, et al. Combination chemotherapy with estramustine phosphate, ifosfamide and cisplatin for hormone-refractory prostate cancer [J]. Acta Med Okayama, 2006, 60(1):43-49.
[18] Dorff TB, Tsao-Wei DD, Groshen S, et al. Efficacy of oxaliplatin plus pemetrexed in chemotherapy pretreated metastatic castration-resistant prostate cancer [J]. Clin Genitourin Cancer, 2013, 11(4):416-422.
doi: 10.1016/j.clgc.2013.07.011
[19] Gasent-Blesa JM, Giner-Marco V, Giner-Bosch V, et al. Phase Ⅱ trial of oxaliplatin and capecitabine after progression to first-line chemotherapy in androgen-independent prostate cancer patients [J]. Am J Clin Oncol, 2011, 34(2):155-159.
doi: 10.1097/COC.0b013e3181d6b453
[20] Flaig TW, Barqawi A, Miller G, et al. A phase Ⅱ trial of dexa-methasone, vitamin D, and carboplatin in patients with hormone-refractory prostate cancer [J]. Cancer, 2006, 107(2):266-274.
doi: 10.1002/(ISSN)1097-0142
[21] Oh WK, Halabi S, Kelly WK, et al. A phase Ⅱ study of estramustine, docetaxel, and carboplatin with granulocyte-colony-stimulating factor support in patients with hormone-refractory prostate carcinoma: Cancer and Leukemia Group B 99813 [J]. Can-cer, 2003, 98(12):2592-2598.
[22] Vlachostergios PJ, Papandreou CN. Targeting neuroendocrine prostate cancer: molecular and clinical perspectives [J]. Front Oncol, 2015, 5:6.
doi: 10.3389/fonc.2015.00006 pmid: 25699233
[23] Pomerantz MM, Spisák S, Jia L, et al. The association between germline BRCA2 variants and sensitivity to platinum-based chemotherapy among men with metastatic prostate cancer [J]. Cancer, 2017, 123(18):3532-3539.
doi: 10.1002/cncr.30808 pmid: 28608931
[24] Mateo J, Carreira S, Sandhu S, et al. DNA-repair defects and olaparib in metastatic prostate cancer [J]. N Engl J Med, 2015, 373(18):1697-1708.
doi: 10.1056/NEJMoa1506859
[25] Ross RW, Beer TM, Jacobus S, et al. A phase 2 study of carbo-platin plus docetaxel in men with metastatic hormone-refractory prostate cancer who are refractory to docetaxel [J]. Cancer, 2008, 112(3):521-526.
doi: 10.1002/(ISSN)1097-0142
[26] Kentepozidis N, Soultati A, Giassas S, et al. Paclitaxel in combination with carboplatin as salvage treatment in patients with castration-resistant prostate cancer: a Hellenic oncology research group multicenter phase Ⅱ study [J]. Cancer Chemother Pharmacol, 2012, 70(1):161-168.
doi: 10.1007/s00280-012-1896-9
[27] Carlin BI, Andriole GL. The natural history, skeletal complications, and management of bone metastases in patients with prostate carcinoma [J]. Cancer, 2000, 88(Suppl 12):2989-2994.
doi: 10.1002/(ISSN)1097-0142
[28] Jocham D, Sommerauer M. Prednisone plus cabazitaxel or mitoxantrone for metastatic castration-resistant prostate cancer progressing after docetaxel treatment: a randomized open-label trial [J]. Eur Urol, 2011, 59(4):659.
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