Journal of Clinical Oncology, Vol 10, 881-889, Copyright © 1992 by American Society of Clinical Oncology
Suramin: a novel growth factor antagonist with activity in hormone- refractory metastatic prostate cancer
C Myers, M Cooper, C Stein, R LaRocca, MM Walther, G Weiss, P Choyke, N Dawson, S Steinberg and MM Uhrich
Clinical Pharmacology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892.
PURPOSE: Suramin is known to inhibit the growth of malignant prostate
carcinoma cells in vitro. This led us to evaluate the effectiveness of
suramin in the treatment of 38 patients with prostate carcinoma refractory
to hormone therapy. PATIENTS AND METHODS: Suramin was administered by
continuous infusion at a rate designed to reach a peak of 300 micrograms/mL
at the end of 14 days. Patients were given 8 weeks to recover from any
toxicity before beginning the second cycle. Subsequent cycles were
administered in the same manner except the starting dose rate was 280
mg/m2. RESULTS: In 17 patients with measurable soft tissue disease, three
had complete disappearance of soft tissue disease for 4, 5, and 11 months,
whereas three patients had a greater than or equal to 50% decrease in the
sum of the products of the diameters of all measurable disease for greater
than or equal to 1 month. Of these 17 patients, pretreatment
prostate-specific antigen (PSA) decreased by 75% or more in five (29%) and
normalized in one (6%). The remaining 21 patients had disease limited to
bone, and only one of these experienced resolution of more than 50% of all
lesions on bone scan. Of these 21 patients, pretreatment PSA decreased by
75% or more in eight (38%) and normalized in five (25%). Median time to
progression for all patients was 26.3 weeks, and median survival was 42.3
weeks. Patients with bone involvement alone exhibited a better survival
than patients with soft tissue involvement (P2 = .02). Survival was
strongly correlated (P2 = .0001) with a decline in the pretreatment PSA of
greater than or equal to 75% by the eighth week on therapy, with nearly an
85% survival at 1 year compared with a 20% survival for those whose
pretreatment PSA did not decline by that amount. CONCLUSION: We conclude
that suramin is an active agent in hormone-refractory prostate carcinoma.
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