Small Cell Carcinoma of the Prostate (SCPC):

Complete Response to
Cyclophosphamide, Doxorubicin ane Etopocide (CDE)

Small cell carcinoma of the prostate (SCPC) is an aggressive tumor with a tendency to metastasize early. The prognosis for patients with this histologic variant of prostate cancer is poor. There is no standard chemotherapy regimen for SCPC. We report a 77 year old patient with stage D-2 SCPC who achieved a CR with Cyclophosphamide, Doxorubicin and Etoposide (CDE). The regimen involved Cyclophosphamide at a dose of 50 mg po bid x 14 days, Etoposide at 50 po qd x 21 days and weekly Doxorubicin at 20 mg iv q wk. Courses were repeated q 29 days. Baseline tumor markers included serum neuron-specific enolase (NSE) of 119 [nl to 12.5], and an LDH of 932. After 1 cycle of CDE the NSE and LDH returned to normal with values of 11.7 and 176 respectively. After 4 cycles of therapy a PET total body scan was normal. The patient is off all therapy after 6 cycles and is now 7 months in complete remission. The regimen was well-tolerated with moderate leukopenia. Alopecia was total. This regimen should be considered in patients with SCPC. A central repository to register patients with this rare variant and to evaluate treatment response to CDE and other protocols is encouraged.