Comparison of estramustine phosphate, methotrexate and cis-platinum in patients with advanced, hormone refractory prostate cancer

S. A. Loening, S. Beckley, M. F. Brady, T. M. Chu, J. B. deKernion, C. Dhabuwala, J. F. Gaeta, R. P. Gibbons, C. F. McKiel, D. G. McLeod, J. E. Pontes, G. R. Prout, P. T. Scardino, J. U. Schlegel, J. D. Schmidt, W. W. Scott, N. H. Slack, M. S. Soloway, G. P. Murphy

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Abstract

In this clinical trial of men with advanced prostatic cancer no longer responsive to hormone therapy 189 were randomized to receive estramustine phosphate, methotrexate or cis-platinum. Response evaluations were done in 158 cases. Objective response rates (complete, partial or stabilization of disease) were 34 per cent for estramustine phosphate, 36 per cent for cis-platinum and 41 per cent for methotrexate. Subjective parameters indicated a substantial advantage for pain improvement with methotrexate or cis-platinum over estramustine phosphate. Probabilities of continued response indicated some advantage for methotrexate and median response durations at this time were twice as long for methotrexate (32 weeks) as for cis-platinum (16 weeks), with estramustine phosphate intermediate (23 weeks). Survival rates for the original treatment randomization groups were not different at this time. Side effects of estramustine phosphate consisted primarily of nausea and vomiting and/or anorexia but to a lesser extent than with cis-platinum. These effects were somewhat less for methotrexate, for which the major side effects were stomatitis and leukopenia, as well as hepatic toxicity reflected by elevated serum glutamic oxaloacetic transaminase levels. Other side effects of cis-platinum were less than for methotrexate (no stomatitis), except for signs of renal toxicity (elevations in blood urea nitrogen and serum creatinine), which were greater. Methotrexate had a relatively high level of activity against metastatic, progressive, hormone nonresponsive prostatic cancer, with side effects that were substantial but manageable.

Original languageEnglish
Pages (from-to)1001-1006
Number of pages6
JournalJournal of Urology
Volume129
Issue number5
StatePublished - Jul 29 1983
Externally publishedYes

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Estramustine
Methotrexate
Cisplatin
Prostatic Neoplasms
Phosphates
Hormones
Stomatitis
Blood Urea Nitrogen
Leukopenia
Anorexia
Random Allocation
Aspartate Aminotransferases
Nausea
Vomiting
Creatinine
Survival Rate
Clinical Trials
Kidney
Pain

ASJC Scopus subject areas

  • Urology

Cite this

Loening, S. A., Beckley, S., Brady, M. F., Chu, T. M., deKernion, J. B., Dhabuwala, C., ... Murphy, G. P. (1983). Comparison of estramustine phosphate, methotrexate and cis-platinum in patients with advanced, hormone refractory prostate cancer. Journal of Urology, 129(5), 1001-1006.

Comparison of estramustine phosphate, methotrexate and cis-platinum in patients with advanced, hormone refractory prostate cancer. / Loening, S. A.; Beckley, S.; Brady, M. F.; Chu, T. M.; deKernion, J. B.; Dhabuwala, C.; Gaeta, J. F.; Gibbons, R. P.; McKiel, C. F.; McLeod, D. G.; Pontes, J. E.; Prout, G. R.; Scardino, P. T.; Schlegel, J. U.; Schmidt, J. D.; Scott, W. W.; Slack, N. H.; Soloway, M. S.; Murphy, G. P.

In: Journal of Urology, Vol. 129, No. 5, 29.07.1983, p. 1001-1006.

Research output: Contribution to journalArticle

Loening, SA, Beckley, S, Brady, MF, Chu, TM, deKernion, JB, Dhabuwala, C, Gaeta, JF, Gibbons, RP, McKiel, CF, McLeod, DG, Pontes, JE, Prout, GR, Scardino, PT, Schlegel, JU, Schmidt, JD, Scott, WW, Slack, NH, Soloway, MS & Murphy, GP 1983, 'Comparison of estramustine phosphate, methotrexate and cis-platinum in patients with advanced, hormone refractory prostate cancer', Journal of Urology, vol. 129, no. 5, pp. 1001-1006.
Loening SA, Beckley S, Brady MF, Chu TM, deKernion JB, Dhabuwala C et al. Comparison of estramustine phosphate, methotrexate and cis-platinum in patients with advanced, hormone refractory prostate cancer. Journal of Urology. 1983 Jul 29;129(5):1001-1006.
Loening, S. A. ; Beckley, S. ; Brady, M. F. ; Chu, T. M. ; deKernion, J. B. ; Dhabuwala, C. ; Gaeta, J. F. ; Gibbons, R. P. ; McKiel, C. F. ; McLeod, D. G. ; Pontes, J. E. ; Prout, G. R. ; Scardino, P. T. ; Schlegel, J. U. ; Schmidt, J. D. ; Scott, W. W. ; Slack, N. H. ; Soloway, M. S. ; Murphy, G. P. / Comparison of estramustine phosphate, methotrexate and cis-platinum in patients with advanced, hormone refractory prostate cancer. In: Journal of Urology. 1983 ; Vol. 129, No. 5. pp. 1001-1006.
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abstract = "In this clinical trial of men with advanced prostatic cancer no longer responsive to hormone therapy 189 were randomized to receive estramustine phosphate, methotrexate or cis-platinum. Response evaluations were done in 158 cases. Objective response rates (complete, partial or stabilization of disease) were 34 per cent for estramustine phosphate, 36 per cent for cis-platinum and 41 per cent for methotrexate. Subjective parameters indicated a substantial advantage for pain improvement with methotrexate or cis-platinum over estramustine phosphate. Probabilities of continued response indicated some advantage for methotrexate and median response durations at this time were twice as long for methotrexate (32 weeks) as for cis-platinum (16 weeks), with estramustine phosphate intermediate (23 weeks). Survival rates for the original treatment randomization groups were not different at this time. Side effects of estramustine phosphate consisted primarily of nausea and vomiting and/or anorexia but to a lesser extent than with cis-platinum. These effects were somewhat less for methotrexate, for which the major side effects were stomatitis and leukopenia, as well as hepatic toxicity reflected by elevated serum glutamic oxaloacetic transaminase levels. Other side effects of cis-platinum were less than for methotrexate (no stomatitis), except for signs of renal toxicity (elevations in blood urea nitrogen and serum creatinine), which were greater. Methotrexate had a relatively high level of activity against metastatic, progressive, hormone nonresponsive prostatic cancer, with side effects that were substantial but manageable.",
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AU - Loening, S. A.

AU - Beckley, S.

AU - Brady, M. F.

AU - Chu, T. M.

AU - deKernion, J. B.

AU - Dhabuwala, C.

AU - Gaeta, J. F.

AU - Gibbons, R. P.

AU - McKiel, C. F.

AU - McLeod, D. G.

AU - Pontes, J. E.

AU - Prout, G. R.

AU - Scardino, P. T.

AU - Schlegel, J. U.

AU - Schmidt, J. D.

AU - Scott, W. W.

AU - Slack, N. H.

AU - Soloway, M. S.

AU - Murphy, G. P.

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N2 - In this clinical trial of men with advanced prostatic cancer no longer responsive to hormone therapy 189 were randomized to receive estramustine phosphate, methotrexate or cis-platinum. Response evaluations were done in 158 cases. Objective response rates (complete, partial or stabilization of disease) were 34 per cent for estramustine phosphate, 36 per cent for cis-platinum and 41 per cent for methotrexate. Subjective parameters indicated a substantial advantage for pain improvement with methotrexate or cis-platinum over estramustine phosphate. Probabilities of continued response indicated some advantage for methotrexate and median response durations at this time were twice as long for methotrexate (32 weeks) as for cis-platinum (16 weeks), with estramustine phosphate intermediate (23 weeks). Survival rates for the original treatment randomization groups were not different at this time. Side effects of estramustine phosphate consisted primarily of nausea and vomiting and/or anorexia but to a lesser extent than with cis-platinum. These effects were somewhat less for methotrexate, for which the major side effects were stomatitis and leukopenia, as well as hepatic toxicity reflected by elevated serum glutamic oxaloacetic transaminase levels. Other side effects of cis-platinum were less than for methotrexate (no stomatitis), except for signs of renal toxicity (elevations in blood urea nitrogen and serum creatinine), which were greater. Methotrexate had a relatively high level of activity against metastatic, progressive, hormone nonresponsive prostatic cancer, with side effects that were substantial but manageable.

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