Review Article

Neoadjuvant Chemotherapy prior to Radical Prostatectomy for Patients with High-Risk Prostate Cancer: A Systematic Review

Table 1

Trials of neoadjuvant chemotherapy to radical prostatectomy.

Authors, referencesNo. of patientsRegimensToxicityFollowupResults

Dreicer et al., [9]29DocetaxelNUT23 m20 patients disease-free
Magi-Galluzzi et al., [10]28DocetaxelNUT49.5 m43% biochemical-free
Febbo et al., [11]19DocetaxelNUT (fatigue and taste disturbances)n/a>50% of   PSA in 58% of patients, no pathological complete response
Chi et al., [12]64Docetaxel plus CAB4 withdrawals42.7 m2 pathological complete responses, 70% recurrence-free survival
Mellado et al., [13]57Docetaxel plus CAB10.1% of patients did not complete the therapy35 m6% pathological complete responses
Kim et al., [14]12 RP/22 RTDocetaxel plus estramustine1 withdrawal24 m>25% of   PSA in 21/22 of patients, 45% progression-free survival
Hussain et al., [15]10 RP/11 RTDocetaxel plus estramustine2 patients with grade 3 deep venous thrombosis, 1 patient with grade 4 neutropenian/aPositive surgical margins in 3 patients
Prayer-Galetti et al., [16]21Docetaxel plus estramustine plus LHRH analogueNUT53 m26% positive surgical margins, 58% organ-confined disease, 42% disease-free, 15% complete response, 80% partial response
Sella et al., [17]22Docetaxel plus estramustine plus CABNUT23.6 m54.5% disease-free survival
Narita et al., [18]18Docetaxel plus estramustine + CABNo grade 3 or 4 toxicities18 m11% pathological complete response, 77.8% disease-free survival
Garzotto et al., [19]22Docetaxel plus mitoxantroneGrade 4 leukopenia, neutropenia, hyperglycemia63 mRecurrence-free survival after 2 y and 5 y was 65.5% and 49.8%
Womble et al., [20]22Docetaxel plus ketoconazole4 withdrawals, 16 patients with grade 3/4 toxicities18 m8/18 biochemical-free
Friedman et al., [21]15Docetaxel plus capecitabineNUTn/aNo pathological complete responses
Ross et al., [22]41Docetaxel plus bevacizumab3 withdrawals, 3 patients with grade 3 neutropenian/a>50% of   PSA in 22% of patients, no pathological complete responses
Shepard et al., [23]18Paclitaxel10 patients with grade 3 and 1 patient with grade 4 neutropenian/a95% PSA decrease, no pathological complete responses
Konety et al., [24]36Paclitaxel plus carboplatin plus estramustine plus CABDeep vein thrombosis in 22% of patients2945% biochemical recurrence-free survival
Clark et al., [25]18Estramustine plus etoposide1 patient with grade 4 pulmonary embolism, 2 patients with grade 3 deep venous thrombosis14 Rate of organ-confined disease, thromboembolism in 3 patients
Garcia et al., [26]28Thalidomide plus GM-CSFNUT325/28 patients had recurrence
Pettaway et al., [27]33Doxorubicin plus ketoconazole plus estramustine plus vinblastine plus CABNUT1317% positive surgical margins, 20/29 patients with no disease recurrence
Weight et al., [28]93 (control study)ExisulindNUTn/aNo effects on biomarkers of cell death

GS: Gleason score; CAB: complete androgen blockade; RP: radical prostatectomy; RT: radiation therapy; NUT: no unexpected toxicities; n/a: not available; GM-CSF: granulocyte-macrophage colony-stimulating factor; m: months; y: years; LHRH: luteinizing hormone-releasing hormone.