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Case Reports in Medicine
Volume 2010 (2010), Article ID 395720, 4 pages
http://dx.doi.org/10.1155/2010/395720
Case Report

Metronomic Treatment with Low-Dose Trofosfamide Leads to a Long-Term Remission in a Patient with Docetaxel-Refractory Advanced Metastatic Prostate Cancer

1Department of Internal Medicine III, University of Ulm, Albert Einstein-Allee 23, 89081 Ulm, Germany
2Department of Urology, University of Ulm, Robert-Koch-Str. 8, 89081 Ulm, Germany
3Department of Nuclear Medicine, University of Ulm, Robert-Koch-Str. 8, 89081 Ulm, Germany
4Internal Medicine, Clinic of Dinkelsbühl, Germany
5IIIrd Department of Medicine, Clinic of Karlsruhe, 76133 Karlsruhe, Germany

Received 23 June 2009; Revised 25 February 2010; Accepted 15 March 2010

Academic Editor: Jonathan Melamed

Copyright © 2010 Jochen Greiner et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The treatment of metastatic prostate cancer patients refractory to androgen withdrawal and docetaxel therapy is currently discouraging and new therapeutic approaches are vastly needed. Here, we report a long-term remission over one year in a 68-year-old patient with metastatic docetaxel-refractory prostate cancer employing low-dose trofosfamide. The patient suffered from distant failure with several bone lesions and lymph node metastases depicted by a (11) C-Choline positron emission tomography/computerized tomography (PET/CT). After initiation of trofosfamide 100 mg taken orally once a day we observed a steadily decreasing PSA value from initial 46.6 down to 2.1  𝜇 g / l . The Choline-PET/CT was repeated after 10 months of continuous therapy and demonstrated a partial remission of the bone lesions and a regression of all involved lymph nodes but one. Taken together we found an astonishing and durable activity of the alkylating agent trofosfamide given in a metronomic fashion. We rate the side effects as low and state an excellent therapeutic ratio of this drug in our patient.