929P - Low-dose dethylstilbestrol in castration-resistant prostate cancer

Date 29 September 2012
Event ESMO Congress 2012
Session Poster presentation I
Topics Prostate Cancer
Presenter Andre Sasse
Authors A. Sasse1, C.L. Nourani2, L.O. Reis3
  • 1Cevon Centre For Evidences In Oncology, UNICAMP - Universidade Estadual de Campinas, BR-13083-887 - Campinas/BR
  • 2Oncology, UNICAMP, Campinas/BR
  • 3Urology, UNICAMP, Campinas/BR

Abstract

Introduction

The role of sequential lines of hormone therapy in castration-resistant prostate cancer (CRPC) remains unclear. Currently, the standard treatment for patients with CRPC is chemotherapy. Diethylstilbestrol (DES) is a synthetic estrogen with anti-tumour properties, which could be effective in these patients, before chemotherapy. OBJECTIVE: To determine the efficacy and safety of low-dose DES in second-line hormonal therapy for CRPC patients in a single institution.

Methods

Between 2007 and 2012, a total of 31 patients with metastatic CRPC received DES 1 mg daily. All patients had progression after central androgenic suppression and at least one line of androgen antagonists (bicalutamide and/or flutamide). Central androgenic supression with bilateral orchiectomy or a gonadotropin-releasing hormone agonist was maintained. Aspirin 100 mg daily was administered to all patients to minimize risk of thromboembolism. The data of PSA response (defined as a 50% reduction), progression-free survival (PFS), overall survival and adverse events were collected and analyzed.

Results

The median age was 76,8 years. The PSA response rate was 55%. After a median follow up of 22 months, the median PFS was 12 months. Only one patient died at the time. The main adverse event was gynecomastia (11/31, 35.4%) and no thrombotic event was recorded.

Conclusion

Low-dose DES appears to be safe and effective for metastatic CRPC before initiating chemotherapy.

Disclosure

All authors have declared no conflicts of interest.