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Zhao J, Guercio BJ, Sahasrabudhe D. Current Trends in Chemotherapy in the Treatment of Metastatic Prostate Cancer. Cancers (Basel) 2023; 15:3969. [PMID: 37568784 PMCID: PMC10417637 DOI: 10.3390/cancers15153969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 07/31/2023] [Accepted: 08/02/2023] [Indexed: 08/13/2023] Open
Abstract
Prostate cancer is the second most common cancer among men. Despite advances in diagnosis and management, prostate cancer led to more than 300,000 deaths globally in 2020. Chemotherapy is a cornerstone of therapy for advanced prostate cancer and can prolong survival of patients with both castration-sensitive and castration-resistant disease. Herein, we present a comprehensive review of the data supporting implementation of chemotherapy in the modern treatment of advanced prostate cancer, with special attention to the use of chemotherapy for aggressive variant prostate cancer (e.g., neuroendocrine prostate cancer) and the combination of chemotherapy with androgen signaling inhibitors. As the field of prostate cancer research continues to rapidly evolve yielding novel agents and treatment modalities, chemotherapy continues to play an essential role in prolonging the survival of patients with advanced and metastatic prostate cancer.
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Affiliation(s)
| | | | - Deepak Sahasrabudhe
- James P. Wilmot Cancer Institute, University of Rochester, Rochester, NY 14642, USA; (J.Z.); (B.J.G.)
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Comparison of docetaxel pharmacokinetics between castration-resistant and hormone-sensitive metastatic prostate cancer patients. Cancer Chemother Pharmacol 2022; 89:785-793. [PMID: 35467095 PMCID: PMC9135852 DOI: 10.1007/s00280-022-04433-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 04/02/2022] [Indexed: 11/11/2022]
Abstract
Purpose Recently, docetaxel treatment of metastatic prostate cancer patients shifted towards the hormone-sensitive stage of the disease. There are contradictive reports on differences in toxicity of docetaxel in metastatic hormone-sensitive prostate cancer (mHSPC) and metastatic castration-resistant prostate cancer (mCRPC) patients. Possible differences in toxicity might be attributed to different pharmacokinetics (PK) in the two patient populations. Methods Patients with mCRPC or mHSPC and a standard indication for docetaxel treatment were included in the study. All patients had suppressed serum testosterone levels (≤ 0.5 ng/mL or 1.73 nmol/L). Venous blood samples were obtained at the first docetaxel treatment, until 48 h after infusion. Plasma concentrations of docetaxel, unbound docetaxel and docetaxel metabolites were measured using validated liquid chromatography coupled tandem mass spectrometry (LC–MS/MS) assays and compared between the two groups. Moreover, serum levels of docetaxel transporting α1-acid glycoprotein were measured and docetaxel toxicity recorded. Results A total of ten mCRPC and nine mHSPC patients were included in the study. The two cohorts differed in the number of prior treatments and opiate use, which were higher for mCRPC patients. The docetaxel PK was not different between mCRPC and mHSPC patients, with areas under the plasma concentration versus time curve (AUC0-48) 1710 [coefficient of variation (CV) 28.4%] and 1486 (CV 25.2%) ng/mL*h (p = 0.27), respectively. Also, the PK profile of unbound docetaxel, M1/M3, M2 and M4 metabolites were similar in both groups. Docetaxel doses were reduced in 50% of the mCRPC patients and 11% of the mHSPC patients. Conclusion The PK profile of docetaxel was similar in mCPRC and mHSPC patients. Therefore, possible differences in toxicity between mCRPC and mHSPC patients cannot be explained by differences in docetaxel PK in our study population. These results suggest that treatment adaptations are not recommended in the new population of patients with mHSPC. Supplementary Information The online version contains supplementary material available at 10.1007/s00280-022-04433-3.
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Chavez-Dominguez R, Perez-Medina M, Aguilar-Cazares D, Galicia-Velasco M, Meneses-Flores M, Islas-Vazquez L, Camarena A, Lopez-Gonzalez JS. Old and New Players of Inflammation and Their Relationship With Cancer Development. Front Oncol 2021; 11:722999. [PMID: 34881173 PMCID: PMC8645998 DOI: 10.3389/fonc.2021.722999] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 11/04/2021] [Indexed: 12/18/2022] Open
Abstract
Pathogens or genotoxic agents continuously affect the human body. Acute inflammatory reaction induced by a non-sterile or sterile environment is triggered for the efficient elimination of insults that caused the damage. According to the insult, pathogen-associated molecular patterns, damage-associated molecular patterns, and homeostasis-altering molecular processes are released to facilitate the arrival of tissue resident and circulating cells to the injured zone to promote harmful agent elimination and tissue regeneration. However, when inflammation is maintained, a chronic phenomenon is induced, in which phagocytic cells release toxic molecules damaging the harmful agent and the surrounding healthy tissues, thereby inducing DNA lesions. In this regard, chronic inflammation has been recognized as a risk factor of cancer development by increasing the genomic instability of transformed cells and by creating an environment containing proliferation signals. Based on the cancer immunoediting concept, a rigorous and regulated inflammation process triggers participation of innate and adaptive immune responses for efficient elimination of transformed cells. When immune response does not eliminate all transformed cells, an equilibrium phase is induced. Therefore, excessive inflammation amplifies local damage caused by the continuous arrival of inflammatory/immune cells. To regulate the overstimulation of inflammatory/immune cells, a network of mechanisms that inhibit or block the cell overactivity must be activated. Transformed cells may take advantage of this process to proliferate and gradually grow until they become preponderant over the immune cells, preserving, increasing, or creating a microenvironment to evade the host immune response. In this microenvironment, tumor cells resist the attack of the effector immune cells or instruct them to sustain tumor growth and development until its clinical consequences. With tumor development, evolving, complex, and overlapping microenvironments are arising. Therefore, a deeper knowledge of cytokine, immune, and tumor cell interactions and their role in the intricated process will impact the combination of current or forthcoming therapies.
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Affiliation(s)
- Rodolfo Chavez-Dominguez
- Departamento de Enfermedades Cronico-Degenerativas, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosio Villegas", Mexico City, Mexico.,Posgrado en Ciencias Biologicas, Universidad Nacional Autonoma de Mexico, Mexico City, Mexico
| | - Mario Perez-Medina
- Departamento de Enfermedades Cronico-Degenerativas, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosio Villegas", Mexico City, Mexico.,Laboratorio de Quimioterapia Experimental, Departamento de Bioquímica, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Mexico City, Mexico
| | - Dolores Aguilar-Cazares
- Departamento de Enfermedades Cronico-Degenerativas, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosio Villegas", Mexico City, Mexico
| | - Miriam Galicia-Velasco
- Departamento de Enfermedades Cronico-Degenerativas, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosio Villegas", Mexico City, Mexico
| | - Manuel Meneses-Flores
- Departamento de Patología, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosio Villegas", Mexico City, Mexico
| | - Lorenzo Islas-Vazquez
- Departamento de Enfermedades Cronico-Degenerativas, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosio Villegas", Mexico City, Mexico
| | - Angel Camarena
- Laboratorio de Human Leukocyte Antigen (HLA), Instituto Nacional de Enfermedades Respiratorias "Ismael Cosio Villegas", Mexico City, Mexico
| | - Jose S Lopez-Gonzalez
- Departamento de Enfermedades Cronico-Degenerativas, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosio Villegas", Mexico City, Mexico
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Xue H, Qin L, Zhang L, Li X, Wu F, Wang W, Wang C, Diao W, Jiang B, Lian B, Wu J, Bai J, Sun T, Zhao C, Qu M, Yu W, Wang Y, Gao Z. Preparation of docetaxel-loaded, glycyrrhetinic acid-modified nanoparticles and their liver-targeting and antitumor activity. Exp Ther Med 2021; 22:1144. [PMID: 34471430 PMCID: PMC8404033 DOI: 10.3892/etm.2021.10578] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 06/25/2021] [Indexed: 01/06/2023] Open
Abstract
Liver cancer is one of the most common malignancies worldwide and poses a serious threat to human health. The most important treatment method, liver cancer chemotherapy, is limited due to its high toxicity and poor specificity. Targeted drug delivery systems have emerged as novel therapeutic strategies that deliver precise, substantial drug doses to target sites via targeting vectors and enhance the therapeutic efficacy. In the present study, glycyrrhetinic acid-modified hyaluronic acid (GA-HA) was used as a carrier for the model drug docetaxel (DTX) to prepare DTX-loaded GA-HA nanoparticles (DTX/GA-HA-NPs). The results indicated that the DTX/GA-HA-NPs exhibited high monodispersity (particle dispersity index, 0.209±0.116) and desirable particle size (208.73±5.0 nm) and zeta potential (-27.83±3.14 mV). The drug loading capacity and encapsulation efficiency of the NPs were 12.59±0.68 and 85.38±4.62%, respectively. Furthermore, it was determined that FITC-GA-HA was taken up by cells and distributed in the cytoplasm. DTX and DTX/GA-HA (just the DTX delivered by the nanoparticle) aggregated and altered the structure of cellular microtubules. Compared with DTX alone, DTX/GA-HA-NPs had a stronger inhibitory effect on HepG2 cell proliferation and promoted apoptosis of HepG2 cells. All experimental results indicated that DTX/GA-HA-NPs were successfully prepared and had liver-targeting and antitumor activities in vitro, which provided a foundation for future in vivo studies of the antitumor effects of DTX/GA-HA-NPs.
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Affiliation(s)
- Hantao Xue
- Shandong Key Laboratory of Medical and Health Sciences, Key Laboratory of Biotechnological Medicine in Universities of Shandong, School of Bioscience and Technology, Weifang Medical University, Weifang, Shandong 261053, P.R. China
| | - Liya Qin
- Shandong Key Laboratory of Medical and Health Sciences, Key Laboratory of Biotechnological Medicine in Universities of Shandong, School of Bioscience and Technology, Weifang Medical University, Weifang, Shandong 261053, P.R. China
| | - Longxiang Zhang
- Department of Pharmacology, Laboratory of Applied Pharmacology, College of Pharmacy, Weifang Medical University, Weifang, Shandong 261053, P.R. China
| | - Xiaocheng Li
- Shandong Key Laboratory of Medical and Health Sciences, Key Laboratory of Biotechnological Medicine in Universities of Shandong, School of Bioscience and Technology, Weifang Medical University, Weifang, Shandong 261053, P.R. China
| | - Fei Wu
- Shandong Key Laboratory of Medical and Health Sciences, Key Laboratory of Biotechnological Medicine in Universities of Shandong, School of Bioscience and Technology, Weifang Medical University, Weifang, Shandong 261053, P.R. China
| | - Weiyu Wang
- Shandong Key Laboratory of Medical and Health Sciences, Key Laboratory of Biotechnological Medicine in Universities of Shandong, School of Bioscience and Technology, Weifang Medical University, Weifang, Shandong 261053, P.R. China
| | - Chen Wang
- Shandong Key Laboratory of Medical and Health Sciences, Key Laboratory of Biotechnological Medicine in Universities of Shandong, School of Bioscience and Technology, Weifang Medical University, Weifang, Shandong 261053, P.R. China
| | - Wenbin Diao
- Shandong Key Laboratory of Medical and Health Sciences, Key Laboratory of Biotechnological Medicine in Universities of Shandong, School of Bioscience and Technology, Weifang Medical University, Weifang, Shandong 261053, P.R. China
| | - Bin Jiang
- Shandong Key Laboratory of Medical and Health Sciences, Key Laboratory of Biotechnological Medicine in Universities of Shandong, School of Bioscience and Technology, Weifang Medical University, Weifang, Shandong 261053, P.R. China
| | - Bo Lian
- Shandong Key Laboratory of Medical and Health Sciences, Key Laboratory of Biotechnological Medicine in Universities of Shandong, School of Bioscience and Technology, Weifang Medical University, Weifang, Shandong 261053, P.R. China
| | - Jingliang Wu
- Shandong Key Laboratory of Medical and Health Sciences, Key Laboratory of Biotechnological Medicine in Universities of Shandong, School of Bioscience and Technology, Weifang Medical University, Weifang, Shandong 261053, P.R. China
| | - Jingkun Bai
- Shandong Key Laboratory of Medical and Health Sciences, Key Laboratory of Biotechnological Medicine in Universities of Shandong, School of Bioscience and Technology, Weifang Medical University, Weifang, Shandong 261053, P.R. China
| | - Tongyi Sun
- Shandong Key Laboratory of Medical and Health Sciences, Key Laboratory of Biotechnological Medicine in Universities of Shandong, School of Bioscience and Technology, Weifang Medical University, Weifang, Shandong 261053, P.R. China
| | - Chunling Zhao
- Shandong Key Laboratory of Medical and Health Sciences, Key Laboratory of Biotechnological Medicine in Universities of Shandong, School of Bioscience and Technology, Weifang Medical University, Weifang, Shandong 261053, P.R. China
| | - Meihua Qu
- Department of Pharmacology, Laboratory of Applied Pharmacology, College of Pharmacy, Weifang Medical University, Weifang, Shandong 261053, P.R. China
| | - Wenjing Yu
- Shandong Key Laboratory of Medical and Health Sciences, Key Laboratory of Biotechnological Medicine in Universities of Shandong, School of Bioscience and Technology, Weifang Medical University, Weifang, Shandong 261053, P.R. China
| | - Yubing Wang
- Shandong Key Laboratory of Medical and Health Sciences, Key Laboratory of Biotechnological Medicine in Universities of Shandong, School of Bioscience and Technology, Weifang Medical University, Weifang, Shandong 261053, P.R. China
| | - Zhiqin Gao
- Shandong Key Laboratory of Medical and Health Sciences, Key Laboratory of Biotechnological Medicine in Universities of Shandong, School of Bioscience and Technology, Weifang Medical University, Weifang, Shandong 261053, P.R. China
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Sun W, Lirio RA, Schneider J, Aubrecht J, Kadali H, Baratta M, Gulati P, Suri A, Lin T, Vasudevan R, Rosario M. Assessment of Vedolizumab Disease-Drug-Drug Interaction Potential in Patients With Inflammatory Bowel Diseases. Clin Pharmacol Drug Dev 2021; 10:734-747. [PMID: 33331142 PMCID: PMC8359401 DOI: 10.1002/cpdd.891] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 11/09/2020] [Indexed: 01/01/2023]
Abstract
Disease-drug-drug interactions (DDDIs) have been identified in some inflammatory diseases in which elevated proinflammatory cytokines can downregulate the expression of cytochrome P450 (CYP) enzymes, potentially increasing systemic exposure to drugs metabolized by CYPs. Following anti-inflammatory treatments, CYP expression may return to normal, resulting in reduced drug exposure and diminished clinical efficacy. Vedolizumab has a well-established positive benefit-risk profile in patients with ulcerative colitis (UC) or Crohn's disease (CD) and has no known systemic immunosuppressive activity. A stepwise assessment was conducted to evaluate the DDDI potential of vedolizumab to impact exposure to drugs metabolized by CYP3A through cytokine modulation. First, a review of published data revealed that patients with UC or CD have elevated cytokine concentrations relative to healthy subjects; however, these concentrations remained below those reported to impact CYP expression. Exposure to drugs metabolized via CYP3A also appeared comparable between patients and healthy subjects. Second, serum samples from patients with UC or CD who received vedolizumab for 52 weeks were analyzed and compared with healthy subjects. Cytokine concentrations and the 4β-hydroxycholesterol-to-cholesterol ratio, an endogenous CYP3A4 biomarker, were comparable between healthy subjects and patients both before and during vedolizumab treatment. Finally, a medical review of postmarketing DDDI cases related to vedolizumab from the past 6 years was conducted and did not show evidence of any true DDDIs. Our study demonstrated the lack of clinically meaningful effects of disease or vedolizumab treatment on the exposure to drugs metabolized via CYP3A through cytokine modulation in patients with UC or CD.
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Affiliation(s)
- Wan Sun
- TakedaCambridgeMassachusettsUSA
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sFLT01 modulates invasion and metastasis in prostate cancer DU145 cells by inhibition of VEGF/GRP78/MMP2&9 axis. BMC Mol Cell Biol 2021; 22:30. [PMID: 34011277 PMCID: PMC8135984 DOI: 10.1186/s12860-021-00367-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 04/20/2021] [Indexed: 02/01/2023] Open
Abstract
Background About 90% of cancer-related deaths are due to metastasis of cancer cells, and angiogenesis is a critical step in this process. sFLT01 is a novel fusion protein and a dual-targeting agent that neutralizes both VEGF and PlGF proangiogenic activities. GRP78 dual effect in tumor growth and angiogenesis could be activated under VEGF stimulation. The current study was designed to investigate the inhibitory impact of sFLT01 protein on VEGF/GRP78 axis. To this point, sFLT01 construct was synthesized, recombinant plasmid was expressed in eukaryotic host cells, sFLT01-HisTag protein was extracted and analyzed. The functional activity of sFLT01 on VEGF-enhanced tube formation and angiogenesis of HUVEC cells were examined. Eventually, the inhibitory impact of sFLT01 on growth, invasiveness, and migration of human prostate cancer cell line, DU145, was assessed. Real-time PCR evaluated the level of GRP78 and its effect on the downstream factors; matrix metallopeptidase proteins 2&9 (MMP2&9) along with tissue inhibitor of metalloproteinase proteins1&2 (TIMP1&2) under sFLT01 stimulation. Results According to the data, sFLT01 protein showed modulatory impact on proliferation, invasion, and migration of DU145 cells along with the potential of HUVECs angiogenesis. Real-Time PCR analysis depicted a significant downregulation in GRP78, MMP2 and MMP9 transcripts’ levels, and a subsequent elevation of TIMP1 and TIMP2 expression under sFLT01 stimulation was detected. Conclusion Overall, these data indicated that the inhibitory impact of sFLT01 on cancer cells growth and invasiveness could be mediated through the modulation of VEGF/GRP78/MMP2&9 axis and activation of TIMPs.
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Chen XY, Yang HW, Chi SM, Yue LL, Ruan Q, Lei Z, Zhu HY, Zhao Y. Solubility and biological activity enhancement of docetaxel via formation of inclusion complexes with three alkylenediamine-modified β-cyclodextrins. RSC Adv 2021; 11:6292-6303. [PMID: 35423130 PMCID: PMC8694830 DOI: 10.1039/d0ra09720a] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 01/28/2021] [Indexed: 12/20/2022] Open
Abstract
Docetaxel (DTX) is an effective and commonly used chemotherapeutic drug for cancer. However, its efficacy is greatly compromised because of its toxicity and poor water solubility. In order to overcome these disadvantages, three inclusion complexes between DTX and alkylenediamine-modified β-cyclodextrins (H1-3) with ethylene, propylene and butylene segments were prepared and characterized. The phase solubility studies demonstrated that the stoichiometry of the inclusion complexes between H1-3 and DTX were 1 : 1. The binding abilities of host H1-3 towards DTX decrease in the following order: H3 > H2 > H1, which had good consistency with the decreasing alkylene lengths of these hosts. The water solubility of DTX is remarkably increased 216, 242 and 253 times after forming inclusion complexes with H1-3, respectively. In vitro release studies of DTX from H1-3/DTX into NaAc-HAc buffer solution (pH 5.0) or PBS (pH 7.4) exhibited a preliminary stage burst effect and followed by a slow drug release. The cytotoxicity studies revealed that the H1-3/DTX inclusion complexes exhibited better cytotoxicity profiles against MCF-7, SW480 and A-549 cells than that of DTX. Furthermore, compared with the treatment of DTX, the H1/DTX inclusion complex significantly increased the cell apoptosis percentage from 17.2% to 30.2% (5 μg mL-1), 19.0% to 31.0% (10 μg mL-1), and 19.3% to 32.2% (15 μg mL-1), respectively. These results will provide useful information for H1-3/DTX inclusion complexes as safe and efficient anticancer drug formulations.
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Affiliation(s)
- Xiang-Yu Chen
- College of Chemistry and Chemical Engineering, Yunnan Normal University Kunming 650500 People's Republic of China +86 871 65941089
| | - Hui-Wen Yang
- College of Chemistry and Chemical Engineering, Yunnan Normal University Kunming 650500 People's Republic of China +86 871 65941089
| | - Shao-Ming Chi
- College of Chemistry and Chemical Engineering, Yunnan Normal University Kunming 650500 People's Republic of China +86 871 65941089
| | - Lu-Lu Yue
- College of Chemistry and Chemical Engineering, Yunnan Normal University Kunming 650500 People's Republic of China +86 871 65941089
| | - Qiong Ruan
- College of Chemistry and Chemical Engineering, Yunnan Normal University Kunming 650500 People's Republic of China +86 871 65941089
| | - Ze Lei
- Guangdong Goodscend Pharmaceutical Technology Co., Ltd Shantou 515098 People's Republic of China
| | - Hong-You Zhu
- Guangdong Goodscend Pharmaceutical Technology Co., Ltd Shantou 515098 People's Republic of China
| | - Yan Zhao
- College of Chemistry and Chemical Engineering, Yunnan Normal University Kunming 650500 People's Republic of China +86 871 65941089
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Exposure to Docetaxel in the Elderly Patient Population: a Population Pharmacokinetic Study. Pharm Res 2019; 36:181. [DOI: 10.1007/s11095-019-2706-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 09/20/2019] [Indexed: 01/20/2023]
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Belderbos BPS, Hussaarts KGAM, van Harten LJ, Oomen-de Hoop E, de Bruijn P, Hamberg P, van Alphen RJ, Haberkorn BCM, Lolkema MP, de Wit R, van Soest RJ, Mathijssen RHJ. Effects of prednisone on docetaxel pharmacokinetics in men with metastatic prostate cancer: A randomized drug-drug interaction study. Br J Clin Pharmacol 2019; 85:986-992. [PMID: 30737835 DOI: 10.1111/bcp.13889] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 02/04/2019] [Accepted: 02/04/2019] [Indexed: 12/24/2022] Open
Abstract
AIMS Docetaxel has been approved for the treatment of metastatic prostate cancer in combination with prednisone. Since prednisone is known to induce the cytochrome P450 iso-enzyme CYP3A4, which is the main metabolizing enzyme of docetaxel in the liver, a potential drug-drug interaction may occur. In this prospective randomized pharmacokinetic cross-over study we investigated docetaxel exposure with concomitant prednisone, compared to docetaxel monotherapy in men with metastatic prostate cancer. METHODS Patients scheduled to receive at least 6 cycles of docetaxel (75 mg/m2 ) and who gave written informed consent were randomized to receive either the 1st 3 cycles, or the last 3 consecutive cycles with prednisone (twice daily 5 mg). Pharmacokinetic blood sampling was performed during cycle 3 and cycle 6. Primary endpoint was difference in docetaxel exposure, calculated as area under the curve (AUC0-inf ) and analysed by means of a linear mixed model. Given the cross-over design the study was powered on 18 patients to answer the primary, pharmacokinetic, endpoint. RESULTS Eighteen evaluable patients were included in the trial. Docetaxel concentration with concomitant prednisone (AUC0-inf 2784 ng*h/mL, 95% confidence interval 2436-3183 ng*h/mL) was similar to the concentration of docetaxel monotherapy (AUC0-inf 2647 ng*h/mL, 95% confidence interval 2377-2949 ng*h/mL). Exploratory analysis showed no toxicity differences between docetaxel monotherapy and docetaxel cycles with prednisone. CONCLUSION No significant difference in docetaxel concentrations was observed. In addition, we found similar toxicity profiles in absence and presence of prednisone. Therefore, from a pharmacokinetic point of view, docetaxel may be administrated with or without prednisone.
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Affiliation(s)
- Bodine P S Belderbos
- Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Koen G A M Hussaarts
- Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Leonie J van Harten
- Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Esther Oomen-de Hoop
- Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Peter de Bruijn
- Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Paul Hamberg
- Department of Internal Medicine, Franciscus Gasthuis & Vlietland, Rotterdam, The Netherlands
| | - Robbert J van Alphen
- Department of Internal Medicine, Elisabeth Twee Steden Ziekenhuis, Tilburg, The Netherlands
| | | | - Martijn P Lolkema
- Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Ronald de Wit
- Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Robert J van Soest
- Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Ron H J Mathijssen
- Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
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