Premium
Oral ethinylestradiol in castration‐resistant prostate cancer: A 10‐year experience
Author(s) -
Sciarra Alessandro,
Gentile Vincenzo,
Cattarino Susanna,
Gentilucci Alessandro,
Alfarone Andrea,
D'Eramo Giuseppe,
Salciccia Stefano
Publication year - 2015
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/iju.12613
Subject(s) - medicine , ethinylestradiol , prostate cancer , concomitant , androgen deprivation therapy , prostate , urology , prostate specific antigen , castration , cancer , oncology , surgery , population , hormone , environmental health , research methodology
Objectives To describe our 10‐year experience with the use of oral ethinylestradiol in the treatment of metastatic castration‐resistant prostate cancer. Methods From F ebruary 2000 to A pril 2010, 116 patients with a metastatic castration‐resistant prostate cancer were prospectively submitted to oral ethinylestradiol monotherapy. Inclusion criteria were: diagnosis of castration‐resistant prostate cancer after failure of at least two lines of androgen deprivation therapy and radiological evidence of metastases. Exclusion criteria were: symptomatic cases with a E uropean C ooperative O ncology G roup score >2 and severe or uncontrolled cardiovascular diseases. At inclusion in the study, all patients discontinued the previous androgen deprivation therapy and started oral ethinylestradiol at the daily dose of 1 mg. Aspirin (100 mg/daily) was concomitantly given. Results The median ethinylestradiol therapy duration was 15.9 months (range 8–36 months), whereas the median follow up of patients was 28 months (range 13–36 months). During ethinylestradiol therapy, a confirmed prostate‐specific antigen response was found in 79 patients (70.5%). The median time to prostate‐specific antigen progression was 15.10 months (95% confidence interval 13.24–18.76 months). A toxicity requiring treatment cessation was observed in 26 patients (23.2%) at a median time of 16 months (mainly thromboembolism). Conclusions Our 10‐year experience shows that ethinylestradiol provides a prostate‐specific antigen response in a high percentage of patients with metastatic castration‐resistant prostate cancer. Cardiovascular toxicity can be managed through accurate patient selection, close follow up and a concomitant anticoagulation therapy.