Chlorambucil and Lomustine in Prostate Cancer
Author Information
Author(s): Shamash J, Dancey G, Barlow C, Wilson P, Ansell W, Oliver R T D
Primary Institution: Department of Medical Oncology, St Bartholomew's Hospital, London EC1A 7BE, UK
Hypothesis
Can the combination of chlorambucil and lomustine re-induce hormone sensitivity in patients with absolute hormone refractory prostate cancer?
Conclusion
The study found that the combination of chlorambucil and lomustine has a low objective response rate but may lead to unexpected re-induction of hormone sensitivity in some patients.
Supporting Evidence
- One patient normalized his PSA levels, and two others had a greater than 50% decline.
- The median time to progression was 3.6 months.
- The overall survival was 7.1 months.
- 47% of patients re-challenged with hormonal therapy had a further PSA reduction.
Takeaway
This study tested two drugs to see if they could help men with a tough type of prostate cancer. They found that while not many men got better, some did respond well after treatment.
Methodology
A phase II study was conducted with 37 patients who received chlorambucil and lomustine after failing other treatments.
Potential Biases
Potential bias due to the lack of a control group and the subjective nature of some outcome measures.
Limitations
The study had a small sample size and a low response rate, which may limit the generalizability of the findings.
Participant Demographics
Median age was 71.4 years, with a performance status range of 0-3, and 89% were symptomatic.
Statistical Information
P-Value
0.085
Confidence Interval
95% CI 2.3–4.9 for time to progression; 95% CI 17.0–29.8 for median survival from androgen independence.
Statistical Significance
p=0.085
Digital Object Identifier (DOI)
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