Docetaxel Followed by Hormone Therapy in Men Experiencing Increasing Prostate-Specific Antigen After Primary Local Treatments for Prostate Cancer

Purpose Prostatectomyor radiation for localized prostate cancer (PC) can fail in up to 15% to 30% of patients. The purpose of this study was to determine feasibility, tolerability, and outcome of docetaxelfollowed by hormone therapyin men experiencing an increasing prostate-specific antigen(PSA) after their primary local treatments for PC. Patients and Methods Men with increasing serum PSA after prostatectomyor/and radiation were eligible. Serum PSA had to be ≥ 4 ng/mL and serum testosterone had to be in the noncastrate range. Treatment included docetaxel70 mg/m2 every 3 weeks for up to six cycles, followed by total androgen suppression( luteinizing hormone-releasing hormone agonist plus bicalutamide) and peripheral androgen blockade ( finasterideplus bicalutamide) for 12 to 20 months. Results Thirty-nine men were enrolled; 32 had PSA-only failure, seven also had clinical metastasis. Baseline median PSA was 13.7 ng/mL. Serum PSA decreased ≥ 50% in 17 of 35 patients (48.5%) and ≥ 75% in seven of 35 p...