Abstract | OBJECTIVES: The purpose of this study was to assess the efficacy and safety of low-dose (1 mg) daily diethylstilbestrol (DES) for the treatment of castrate-resistant prostate cancer (CRPC). MATERIALS AND METHODS: A retrospective chart review was performed on patients treated with low-dose DES who had CRPC despite anti- androgen withdrawal. The study population consists of 63 patients treated in the pre- and post- chemotherapy settings based on a database review; 58 had sufficient data for efficacy, all were analyzed for safety. RESULTS: A PSA decrease of ≥50% was observed in 19 of 49 pre- chemotherapy patients (39%) with a median time to progression ( TTP) of 30 weeks (95% CI, 21.9, 68.7). A PSA decrease of <50% was seen in another 16 patients (33%) with a median TTP of 16.4 weeks (95% CI, 13.0, 37.6). Fourteen patients (29%) had progressive disease by PSA testing; their median TTP was 6.9 weeks (95% CI, 5.6, 12.9). Thromboembolic events included 2 patients with DVTs and 1 patient who developed primary fibrinolysis syndrome. Additional adverse events included gynecomastia in 37 of 63 patients (59%). Secondary observations included PSA responses in 3 of 9 patients treated with DES after chemotherapy progression and a high rate of PSA responses in patients re-treated with DES after a drug holiday. CONCLUSIONS: Low-dose DES is safe and effective in a modern cohort of men with CRPC despite anti- androgen treatment. Its potential role in the post- chemotherapy setting and the suggestion of efficacy on re-challenge merits additional consideration.
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Authors | Julia Clemons, L Michael Glodé, Dexiang Gao, Thomas W Flaig |
Journal | Urologic oncology
(Urol Oncol)
Vol. 31
Issue 2
Pg. 198-204
(Feb 2013)
ISSN: 1873-2496 [Electronic] United States |
PMID | 21795073
(Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
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Copyright | Copyright © 2013 Elsevier Inc. All rights reserved. |
Chemical References |
- Antineoplastic Agents
- Diethylstilbestrol
- Prostate-Specific Antigen
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Topics |
- Aged
- Aged, 80 and over
- Antineoplastic Agents
(administration & dosage, therapeutic use)
- Diethylstilbestrol
(administration & dosage, therapeutic use)
- Drug Resistance, Neoplasm
- Humans
- Kaplan-Meier Estimate
- Male
- Middle Aged
- Prostate-Specific Antigen
(blood)
- Prostatic Neoplasms
(drug therapy, mortality)
- Retrospective Studies
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