Carboplatin + etopside in mCRPC: high toxicity and low efficacy

The results of the French Genito-Urinary Tumor Group (GETUG) P01 trial — a Phase II study of carboplatin and etoposide in men with progressive metastatic castration-resistant prostate cancer (mCRPC) — have shown that this form of combination chemotherapy has limited efficacy and an unacceptably high toxicity in men with late stage prostate cancer.

About 20 percent of patients with mCRPC present with visceral (soft tissue) metastases with or without neuroendocrine differentiation. Between April 2005 and January 2008, Fléchon et al. enrolled 60 mCRPC patients with either neuroendocrine differentiation or visceral metastases into a trial of the efficacy and safety of  a combination of carboplatin and etoposide dosed every 3 weeks.

The results of this study were as follows:

  • 47/60 patients (78.6 percent) had bone metastases.
  • 28/60 patients (46.4 percent) had lymph node involvement.
  • 34/60 patients (57.1 percent) had liver and/or lung metastases.
  • The average (median) follow-up was 9.3 months.
  • Average (median) overall survival was 9.6 months.
  • The overall objective response rate was just 8.9 percent in the 46 patients with measurable disease.
  • The PSA response rate was just 8 percent.
  • Treatment-related toxicities of grades 3 and 4 included
    • Neutropenia (in 65.5 percent of patients)
    • Thrombocytopenia (in 32.7 percent of patients)
    • Anemia (in 27.3 percent of patients).
  • One patient died from febrile neutropenia.

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