Phase II trial of suramin, leuprolide, and flutamide in previously untreated metastatic prostate cancer

N. A. Dawson, W. D. Figg, M. R. Cooper, O. Sartor, Raymond Bergan, A. M. Senderowicz, S. M. Steinberg, A. Tompkins, B. Weinberger, E. A. Sausville, E. Reed, C. E. Myers

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Purpose: To assess the efficacy and toxicity of suramin, hydrocortisone, leuprolide, and flutamide in previously untreated metastatic prostate cancer. Patients and Methods: Patients with stage D2 and poor-prognosis stage D1 prostate cancer were given suramin on a pharmacokinetically derived dosing schedule to maintain suramin concentrations between 175 and 300μg/mL. Additionally, all patients received flutamide 250 mg orally three times daily, initiated on day 1 and continued until disease progression; depot leuprolide 7.5 mg intramuscularly begun on day 5 and repeated every 4 weeks indefinitely; and replacement doses of hydrocortisone. Results: Fifty patients were entered onto the study: 48 with stage D2 and two with stage D1 disease. The median age was 59 years (range, 42 to 79) and 31 patients had a Karnofsky performance status (KPS) of 100%. Forty-five patients had bane metastases and 25 had measurable soft tissue disease. Forty-one (82%) had severe disease. The overall response rate in 49 assessable patients was three complete responses (CRs) and 30 partial responses (PRs) for an overall response rate of 67%. Eighteen patients have died. The median survival time has not been reached, with a median potential follow-up duration of 44 months. Grade 3 to 4 toxicity was seen in 38% of patients and was predominantly hematologic and reversible. Conclusion: The high response rate and prolonged survival in a poor-prognosis group of patients with metastatic prostate cancer warrant a phase III randomized comparison of this regimen versus hormonal therapy alone. Toxicity was moderate and reversible.

Original languageEnglish (US)
Pages (from-to)1470-1477
Number of pages8
JournalJournal of Clinical Oncology
Volume15
Issue number4
StatePublished - Apr 1997
Externally publishedYes

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Leuprolide
Flutamide
Suramin
Prostatic Neoplasms
Hydrocortisone
Karnofsky Performance Status
Disease Progression
Appointments and Schedules
Survival Rate
Neoplasm Metastasis

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Dawson, N. A., Figg, W. D., Cooper, M. R., Sartor, O., Bergan, R., Senderowicz, A. M., ... Myers, C. E. (1997). Phase II trial of suramin, leuprolide, and flutamide in previously untreated metastatic prostate cancer. Journal of Clinical Oncology, 15(4), 1470-1477.

Phase II trial of suramin, leuprolide, and flutamide in previously untreated metastatic prostate cancer. / Dawson, N. A.; Figg, W. D.; Cooper, M. R.; Sartor, O.; Bergan, Raymond; Senderowicz, A. M.; Steinberg, S. M.; Tompkins, A.; Weinberger, B.; Sausville, E. A.; Reed, E.; Myers, C. E.

In: Journal of Clinical Oncology, Vol. 15, No. 4, 04.1997, p. 1470-1477.

Research output: Contribution to journalArticle

Dawson, NA, Figg, WD, Cooper, MR, Sartor, O, Bergan, R, Senderowicz, AM, Steinberg, SM, Tompkins, A, Weinberger, B, Sausville, EA, Reed, E & Myers, CE 1997, 'Phase II trial of suramin, leuprolide, and flutamide in previously untreated metastatic prostate cancer', Journal of Clinical Oncology, vol. 15, no. 4, pp. 1470-1477.
Dawson, N. A. ; Figg, W. D. ; Cooper, M. R. ; Sartor, O. ; Bergan, Raymond ; Senderowicz, A. M. ; Steinberg, S. M. ; Tompkins, A. ; Weinberger, B. ; Sausville, E. A. ; Reed, E. ; Myers, C. E. / Phase II trial of suramin, leuprolide, and flutamide in previously untreated metastatic prostate cancer. In: Journal of Clinical Oncology. 1997 ; Vol. 15, No. 4. pp. 1470-1477.
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abstract = "Purpose: To assess the efficacy and toxicity of suramin, hydrocortisone, leuprolide, and flutamide in previously untreated metastatic prostate cancer. Patients and Methods: Patients with stage D2 and poor-prognosis stage D1 prostate cancer were given suramin on a pharmacokinetically derived dosing schedule to maintain suramin concentrations between 175 and 300μg/mL. Additionally, all patients received flutamide 250 mg orally three times daily, initiated on day 1 and continued until disease progression; depot leuprolide 7.5 mg intramuscularly begun on day 5 and repeated every 4 weeks indefinitely; and replacement doses of hydrocortisone. Results: Fifty patients were entered onto the study: 48 with stage D2 and two with stage D1 disease. The median age was 59 years (range, 42 to 79) and 31 patients had a Karnofsky performance status (KPS) of 100{\%}. Forty-five patients had bane metastases and 25 had measurable soft tissue disease. Forty-one (82{\%}) had severe disease. The overall response rate in 49 assessable patients was three complete responses (CRs) and 30 partial responses (PRs) for an overall response rate of 67{\%}. Eighteen patients have died. The median survival time has not been reached, with a median potential follow-up duration of 44 months. Grade 3 to 4 toxicity was seen in 38{\%} of patients and was predominantly hematologic and reversible. Conclusion: The high response rate and prolonged survival in a poor-prognosis group of patients with metastatic prostate cancer warrant a phase III randomized comparison of this regimen versus hormonal therapy alone. Toxicity was moderate and reversible.",
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AU - Dawson, N. A.

AU - Figg, W. D.

AU - Cooper, M. R.

AU - Sartor, O.

AU - Bergan, Raymond

AU - Senderowicz, A. M.

AU - Steinberg, S. M.

AU - Tompkins, A.

AU - Weinberger, B.

AU - Sausville, E. A.

AU - Reed, E.

AU - Myers, C. E.

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N2 - Purpose: To assess the efficacy and toxicity of suramin, hydrocortisone, leuprolide, and flutamide in previously untreated metastatic prostate cancer. Patients and Methods: Patients with stage D2 and poor-prognosis stage D1 prostate cancer were given suramin on a pharmacokinetically derived dosing schedule to maintain suramin concentrations between 175 and 300μg/mL. Additionally, all patients received flutamide 250 mg orally three times daily, initiated on day 1 and continued until disease progression; depot leuprolide 7.5 mg intramuscularly begun on day 5 and repeated every 4 weeks indefinitely; and replacement doses of hydrocortisone. Results: Fifty patients were entered onto the study: 48 with stage D2 and two with stage D1 disease. The median age was 59 years (range, 42 to 79) and 31 patients had a Karnofsky performance status (KPS) of 100%. Forty-five patients had bane metastases and 25 had measurable soft tissue disease. Forty-one (82%) had severe disease. The overall response rate in 49 assessable patients was three complete responses (CRs) and 30 partial responses (PRs) for an overall response rate of 67%. Eighteen patients have died. The median survival time has not been reached, with a median potential follow-up duration of 44 months. Grade 3 to 4 toxicity was seen in 38% of patients and was predominantly hematologic and reversible. Conclusion: The high response rate and prolonged survival in a poor-prognosis group of patients with metastatic prostate cancer warrant a phase III randomized comparison of this regimen versus hormonal therapy alone. Toxicity was moderate and reversible.

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