Korean J Urol.  2007 Jul;48(7):751-753. 10.4111/kju.2007.48.7.751.

Dramatic Decline of PSA and Symptom Improvement after Estramustine Withdrawal in a Hormone-refractory Prostate Cancer Patient

Affiliations
  • 1Department of Urology, College of Medicine, Dongguk University, Gyeongju, Korea. ksleemd@dongguk.ac.kr

Abstract

In some patients with prostate cancer and who manifest disease progression during maximal androgen blockade(MAB) therapy, discontinuation of antiandrogen treatment might result in a significant fall in the level of serum prostate-specific antigen(PSA), and this is often correlated with clinical improvement(antiandrogen withdrawal syndrome). However, a decline in the PSA level after the withdrawal of estramustine phosphate is extremely rare. We report here on a case of dramatic decline in the PSA level after withdrawal of estramustine phosphate in a patient with hormone refractory prostate cancer.

Keyword

Prostate cancer; Estramustine; Chemotherapy

MeSH Terms

Disease Progression
Drug Therapy
Estramustine*
Humans
Prostate*
Prostatic Neoplasms*
Estramustine

Figure

  • Fig. 1. Serial changes of bone scan finding. (A) Initial bone scan, (B) 38 months later (after second line hormone therapy), (C) 57 months later (after estramustine withdrawal).

  • Fig. 2. Clinical course. The serum prostate-specific antigen (PSA) level declined dramatically after the withdrawal of estramustine phosphate. PSA: prostate-specific antigen, MAB: maximal androgen blockade, GnRH: gonadotrophin releasing hormone, K: ketoconazole, P: prednisolone, E: estramustine, V: vinblastine.


Reference

References

1. Kelly WK, Scher HI. Prostate-specific antigen decline after antiandrogen withdrawal: the flutamide withdrawal syndrome. J Urol. 1993; 149:607–9.
2. Nishiyama T, Terunuma M. Hormone/antihormone withdrawal and dexamethasone for hormone-refractory prostate cancer. Int J Urol. 1998; 5:44–7.
Article
3. Shibata Y, Morita T, Kashiwagi B, Tomizawa H, Yamanaka H. Estramustine phosphate withdrawal syndrome with dramatic pain relief. J Urol. 1999; 162:805.
Article
4. Kobayashi M, Kuramoto H, Ota J, Fujimoto N. Dramatic decline in prostate-specific antigen by withdrawal of estramustine phosphate in hormone refractory prostate cancer. Int J Urol. 2006; 13:1019–21.
Article
5. Miyamoto H, Rahman MM, Chang C. Molecular basis for the antiandrogen withdrawal syndrome. J Cell Biochem. 2004; 91:3–12.
Article
6. Suzuki H, Akakura K, Komiya A, Aida S, Akimoto S, Shimazaki J. Codon 877 mutation in the androgen receptor gene in advanced prostate cancer: relation to antiandrogen withdrawal syndrome. Prostate. 1996; 29:153–8.
Article
7. Gottlieb B, Lehvaslaiho H, Beitel LK, Lumbroso R, Pinsky L, Trifiro M. The androgen receptor gene mutations database. Nucleic Acids Res. 1998; 26:234–8.
Article
8. Hudes G, Einhorn L, Ross E, Balsham A, Loehrer P, Ramsey H, et al. Vinblastine versus vinblastine plus oral estramustine phosphate for patients with hormone-refractory prostate cancer: A Hoosier Oncology Group and Fox Chase Network phase III trial. J Clin Oncol. 1999; 17:3160–6.
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