Combined Therapy of Advanced Prostatic Carcinoma with Estramustine and Prednimustine

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Abstract
Patients (21) with stage D prostatic adenocarcinoma who had unsuccessful hormonal therapy were treated with a combination of 600 mg/m2 per day estramustine phosphate (Estracyt) and 15 mg/m2 per day prednimustine (Stereocyt, Leo 1031) in daily oral doses. Estramustine is a combination of estradiol and nitrogen mustard, and alone has shown objective responses in advanced prostatic cancer. Prednimustine is an ester of chlorambucil and prednisone. The preliminary results (after 2-9 mo. of therapy) show 5 patients (24%) with objective responses and 9 (44%) with subjective improvement. Only 5 patients (24%) did not benefit from the drug and 7 patients (33%) are stable. These preliminary results indicate the possible advantage of adding an alkylating agent (prednimustine) to estramustine in advanced prostatic carcinoma. A national randomized trial by the National Prostatic Cancer Project is evaluating this therapeutic innovation.