lol, lol

PSA Report for Steve Kramer AND or PLUS more stuff.......

That's what I get for doing two things at once......

Dan, here you go:

Trial of Chemotherapy plus Hormonal Therapy as Initial Treatment for
Unresectable / Metastatic Adenocarcinoma of the Prostate

H. Henary, R.J. Amato; The Methodist Hospital/The Methodist Hospital
Research Institute/Genitourinary Program, Houston, TX

Background: Chemotherapy is a setting of hormone refractory prostate cancer
has shown palliative benefit especially with substantial PSA decline
strongly suggesting that disease modifying potential exists. Recently,
chemotherapy is beginning to show a survival advantage. The stage is set for
chemotherapy given earlier in a disease course. As a working hypothesis, we
suspect that the transformation from an androgen-dependent to an
androgen-independent phenotype is mediated by the expansion of an
androgen-independent clone already present at the time of androgen
deprivation. If this model is correct, then it would be desirable to bring
treatment to bear on the androgen-independent component when the
corresponding tumor burden is minimal. Thus, we view the
androgen-independent component as analogous to $B!H(Bmicroscopic residual$B!I(B or
$B!H(Bmicro-metastatic$B!I(B disease for which adjuvant chemotherapy has shown to be
effective in other contexts.

Methods: Each course of chemotherapy lasts for 8 weeks. Patients were
treated in weeks 1, 3, and 5 with doxorubicin 20 mg/m2 as a 24-hour
intravenous infusion on the first day of every week in combination with
ketoconazole 400 mg orally 3 times a day daily for 7 days. In weeks 2, 4,
and 6, treatment consisted of paclitaxel 100 mg/m2 intravenously on the
first day of every week in combination with estramustine 280 mg orally 3
times a day for 7 days. After completion of 3 courses of chemotherapy,
hormone management [medical castration plus casodex (at the completion of
chemotherapy)] is initiated at the start of chemotherapy and for a total of
24 months.

Results: Nineteen men have been enrolled with a median age of 63 (48-76).
Fifty percent of the men had no prior local therapy, while the other 50%
either failed surgery, radiation therapy, or surgery plus radiation therapy.
Fifty-nine percent of the men had Gleason 7, 12%/8, 24%/9, and 5%/10.
Thirty-five patients presented with bone metastasis and 50% presented with
nodal involvement. The median PSA reduction to date has been 95.6%.

Conclusion: Enrollment is ongoing. Further information regarding PSA
response, associated radiographic response, and toxicity will be presented.

Note, in my case Casodex was stopped six months after chemo ended.

Gourd Dancer