Transdermal estradiol in castrate and chemotherapy resistant prostate cancer

Mark Stein, Susan Goodin, Susan Doyle-Lindrud, Jeffrey Silberberg, Michael Kane, Dorinda Metzger, Simantini Eddy, Weichung Shih, Robert S. DiPaola

Research output: Contribution to journalArticlepeer-review

16 Scopus citations

Abstract

Background: Given prior studies demonstrating the marked clinical activity of oral estrogens in prostate cancer, more recent data demonstrating the safety of transdermal estradiol, and the renewed interest in targeting testosterone metabolism and androgen receptor pathways, we report the results of a trial of transdermal estradiol in advanced heavily pre-treated castrate and chemotherapy refractory patients. Material/Methods: Patients with prostate cancer progressing after androgen ablation therapy and chemotherapy were treated with transdermal estradiol patches (0.4 mg per 24 hours total) applied weekly and assessed for tolerability and biochemical activity. Results: Twenty-two patients were treated on study with all patients evaluable for safety and 20 patients evaluable for response. All patients had aggressive and resistant disease, as demonstrated by a median PSA of 170 ng/mL (range 14 to 5030 ng/mL), with more than 60% having been treated with two or more prior chemotherapy regimens, and 20% with visceral disease. Nine patients had a decrease in PSA, of which two patients had a PSA response defined as a decline in PSA by 50%. Therapy was well tolerated and no thrombotic events were observed. Conclusions: In heavily pre-treated patients with advanced castrate and chemotherapy refractory metastatic prostate cancer, transdermal estradiol was safe and had biochemical activity. These data support further studies to understand if transdermal estradiol can be useful following multiple standard therapies.

Original languageEnglish
Pages (from-to)CR260-CR264
JournalMedical Science Monitor
Volume18
Issue number4
DOIs
StatePublished - 2012

Funding

FundersFunder number
National Childhood Cancer Registry – National Cancer InstituteP30CA072720

    Keywords

    • Abiraterone
    • Estradiol
    • Prostate cancer
    • Testosterone

    ASJC Scopus subject areas

    • General Medicine

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