Epirubicin carboplatin and 5-fluorouracil (ECarboF) chemotherapy in metastatic hormone refractory prostate cancer

The aim of this study was to examine the efficacy and toxicity of the epirubicin, carboplatin and 5-fluorouracil (ECarboF) regime in patients aged 70 or less with metastatic prostate cancer resistant to LHRH analogues. The majority of patients had previously received steroids as part of their systemic management and had progressive disease on steroids. In total, 80 patients were treated over a 6-year period, with objective response rates (PSA or radiological) of 45% and median time to relapse of 9.5 months. Median survival of the group was 9.2 months. In all, 32% of patients were alive at 12 months. Grade 3/4 neutropenia occurred in 34% of patients with an 8.7% rate of neutropenic sepsis. Grade 3/4 nonhaematological toxicity occurred in 28% of patients. For a substantial minority of patients with hormone refractory prostate cancer, combination chemotherapy can induce remission of significant duration. While similar responses have been documented for systemic cytotoxic-steroid combinations, the responses in this study are likely to reflect the activity of cytotoxic drugs alone.