Comparison of Estramustine Phosphate and Vincristine Alone or in Combination for Patients with Advanced, Hormone Refractory, Previously Irradiated Carcinoma of the Prostate

Abstract

A total of 121 men with hormonally refractory metastatic cancer of the prostate were randomized to receive estramustine phosphate or vincristine or the combination of these 2 agents. All patients had received prior radiation therapy (greater than 2000 rad). There were 90 patients who could be compared for response. The objective respone rates (partial regression or stabilization of disease) for the 3 treatment groups were 26% for estramustine phosphate, 24% for estramustine phosphate plus vincristine and 15% for vincristine. Subjective parameters varied little among the 3 regimens. The median duration of response for those responding to estramustine phosphate was similar (20 wk) to that for vincristine (22 wk) and greater than that for the combination (13 wk). The probability of survival did not differ significantly for patients randomized to each of the 3 regimens. The addition of vincristine to estramustine phosphate did not enhance the response rate achieved by estramustine phosphate alone; vincristine alone produced the lowest response rate. Estramustine phosphate continues to be the most active agent in previously irradiated patients with hormonally refractory metastatic cancer of the prostate.