Metastatic hormonorefractory prostate cancer: treatment of disease progression after taxanes based chemotherapy

Taxanes represent the most active first-line treatment for metastatic hormone refractory prostate cancer. However, most patients progress while receiving taxanes-based treatment and require a second-line approach. The aim of the present study was to evaluate the activity and the safety of the combination of bevacizumab and taxanes in patients with metastatic, hormone refractory prostate cancer with evidence of disease progression after a previous docetaxel-based chemotherapy. METHODS. Twenty patients were enrolled into the study protocol. Treatment consisted of bevacizumab (10 mg/kg) plus docetaxel (60 mg/m2) administered every three weeks. Biochemical and objective responses, progression-free survival, overall survival, and toxicity were evaluated. RESULTS. 55% of patients had a PSA reduction ≥ 50%, 10% had a PSA reduction ≥ 25% to 49%, 10% had a PSA reduction < 25% or a PSA increase <25%, and 25% had a PSA increase ≥ 25%. Three patients with measurable disease had an objective response. Median progression-free survival and median overall survival were 4 months and 9 months, respectively. Treatment was well tolerated. CONCLUSIONS. The combination of bevacizumab and docetaxel is active and well tolerated in patients with metastatic hormone refractory prostate cancer with evidence of progression after a previous docetaxel-based chemotherapy.