Researchers, Nelius T, Klatte T, de Riese W, Haynes A, Filleur S. from the Department of Urology, Texas Tech University Health Sciences Center, Lubbock, TX. studied the efficacy of cyclophosphamide (CP)-based metronomic chemotherapy in men who have docetaxel-resistant hormone-refractory prostate cancer (HRPC).
To be included in the study men have to have confirmed metastatic HRPC and have disease progression while being under docetaxel-based chemotherapy. The study’s primary endpoint was prostate-specific antigen (PSA) response. Secondary endpoints were survival and toxicity.
Low-dose CP (50 mg/d) and dexamethasone (1 mg/d) were given in a metronomic manner (low dose). Treatment was continued until disease progression or intolerable side effects occurred.
A total of seventeen men were enrolled in this study. The median follow-up was 12 weeks (range: 4-60). Median age was 68 years (range: 42-85). Median PSA at study entry was 134 ng/ml (range: 46.0-6554).
Nine men had a PSA response (median 44.4%); four men had a greater than 50% response and five men had a less than 50% PSA response. Eight men eventually experienced a PSA progression. The overall survival was 24 months. Five men reported a decrease in bone pain after 4 weeks of treatment. As opposed to Jevtana (cabazitaxe) no grade 3 and 4 toxicities were noted.
Given the lack of alternative treatments this study supports the use of low-dose metronomically administered CP. It did demonstrate a level of efficacy as a second-line treatment in patients with docetaxel-resistant HRPC. Additionally, the treatment was well tolerated and almost without toxicity.
Further advantages of low-dose CP were its convenient oral administration, dosing schedule, low cost, and low-toxicity profile. These attributes in combination with immuno-regulatory and antiangiogenic potentials make Cyclophosphamideals a prime candidate for additional study for post chemotherapy and as a possible combination drug to be used with other treatment regimens.
Med Oncol. 2010 Jun;27(2):569.; , Nelius T, Klatte T, de Riese W, Haynes A, Filleur S.
Joel T Nowak, MA, MSW
I HAD RP SEVEN YEARS AGO PSA AT TIME 6.80, GLEASON 4+3= 7. AFTER SURGERY, PSA WAS 0.16. IT STAYED THERE FOR ABOUT NINE
MONTHS, THEN IT CAME TO 1.36, AND I HAVE RADIOTHERAPY. IT CAME DOWN TO ABOUT O.O2. IT STAYED THERE FOR TWO YEARS AND IT BEGAN TO RAISE TO O.40, THEN THEY STARTED CASODEX OR FENATRIDE, FOR 8 MONTHS IT REMANINED THERE TO ABOUT O.04. IT WAS SUSPENDED AND STARTED AGAIN TO O.40 AND FINALLY IT CAME TO 3.87 IN JANUARY 2010, AFTER THAT THEY STARTED ON CYCLOPHOSPHAMIDE 150 MGS PER DAY FOR FOURTEEN DAY AND 21 DAYS OF PRENIDSONA, OF 5 MG,
TWICE A DAY, IN SEVEN MOTHS IT CAME TO 0.83, IT STAYED THERE FOR 10 MOTHS, AND NOW IT STARTED TO RAISE A LITTLE BIT TO 0.99, 21 DAYS AGO ,AND TODAY AFTER OTHER 21 DAYS TO 1.07.
MY OTHER RESULTS, HEMOGRAMS, KIVER TEST SGOT, SGPT, BUM CEA CEA 125, ETC, ALL AND I MEAN AREA NORMAL. I AM UNDER A 21 DAY MEDICAL SUPERVISION, BY ONE OF THE FINEST IF NOT THE FINES ONCOLOGY IN THE DOMINICAN REP. MY TUMOR WAS T2A.
I HAVE A VERY ACTIVE LIFE, MAINTAIN AS THROUGHOUT MY LIFE A
VERY CONSERVATIVE DIET, COLOR AND VEGETABLES FRUIT AND NO FAT.
COLESTEROL, LDLETC ARE BELOW NORMAL, HDL 87. SO I AM IN GOOD HEALTH.
WILL THIS TREATMENT OF CYCLO- AND PRENIDSONA, CAN MANTAIN AS THEY HAVE DONE THE PSA, UNDE REGULAR VALUES, I MEAN LOW VALUES THAT THEY CAN NOT INCREASE. I TAKE LUPRON VACCINE EVERY MONTH AND A ZOMETA EVERY THREE MONTHS.
CAN YOU INDICATE ME IF THIS CHEMIO WILL WORK ON ANON AGRESSIVE TYPE OF TUMOR AS DESCRIBED BY THE PATOLOGY AFTER SURGERY.
PLEASE ANY HELP, WILL BE GRATEFULLY APPRECIATED.
IT HAS BEE SEVEN YEARS COMING APRIL26, THAT I HAD SURGERY,
IT HAS BEEN A TREMNDOUS EFFORT ON THE PART OF OUR FAMILY TO
GO THROUGTH THIS PROCESS, BUT THERE IS GOD AND GOOD PERSON LIKE YOU.
PLEASE LET ME KNOW YOUR INFORMATION ON THIS.
GOD BLESS YOU ALL.
Is there any other hormone therapy that might be available, like Lupron? – Joel
DR. JOEL, THANK YOU FOR YOUR ANSWER.
LET ME EXPLAIN ABOUT CYCLOPHOSPHAMIDE AND PRENIDSONA, TREATMENT.
I HAD 3.87 PSA, JANUARY, 4, 2011. AND THEY BEGAN THE TREATMENT
14 DAYS CYCLOPHOSPAHMIDE, COSECUTEVILY AND 21 DAYS OF PRENIDSONA. AT DAY 20 RESULTS, PSA, SGOT, SGPT, HEMOGRAM, BUN,
CALCIUM ALCALINE PHOSPHATE, CREATININE, ETC. AT 21 DAYS A CHECK UP WITH MY ONCOLOGIS, DR. ALAM,A PHYSICAL CHEK UP,
TESTING FOR EVERYTHING AND THEM GO BACK FOR MORE 21 DAYS.
AS OF TODAY I HAVE A PSA OF 0.33 AND GOING DOWN, WE EXPECT
THIS ON TUESDAY THE 22 TO BE IN THE NEIBORGHOOD OF 0.22,
MAY GODS WILLING.
CYCLOPHOSHAMIDE IS CHEAP, AROUND, 12.00 DOLARS THE 50 PILLS,
AND PRENIDSONA IS AROUND 2.50 DOLARS 50 UNITS.
I HOPE I CAN CONTRIBUTE TO HELP MANY PEOPLE, I TRUST DR. N. ALAM, OUSTANDING ONCOLOGY, AND ALSO GOD.
PERHAPS SOME GOOD COMES OUT OF THIS.