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Peplomycin in the treatment of prostatic carcinoma


Acta Urologica Japonica 28(1): 49-56
Peplomycin in the treatment of prostatic carcinoma
Eleven patients with prostatic carcinoma were treated with peplomycin, a derivative of bleomycin. They were aged from 62-84 yr and clinically classified (by the Whitemore classification) as follows: 1 in stage A, 3 in stage B, 3 in stage C and 4 in stage D. Peplomycin was administered on the dosage schedule of 5 of 10 mg at a time, 3 times/wk, to the target total dose of 180 mg. The effects of this drug against prostatic carcinoma were evaluated in terms of the following: changes in the size of the prostate; changes in acid phosphatase activity; the trend of bone metastasis: histopathological findings after the treatment; and long-term survival. The adverse reactions to the treatment were also studied. The patients received peplomycin to the total doses of 80-190 mg (135 mg on the average); the drug was withdrawn from 5 of them for adverse reactions. At the end of the treatment, the prostate was reduced in size in 7 patients and unchanged in 3. Acid phosphatase activity, which had been elevated in 5, was normal in all 5 patients at the end of treatment. Bone metastases had been noted in 4 of the 11 patients, but the clinical symptom (pain) had disappeared from all 4 patients at the end of treatment. The post-treatment histopathological findings of the prostate tissue specimens obtained by TUR [transurethral resection] were grade IIa in 1, grade IIb in 3, grade III in 4 and grade IVa in 3 of the patients by the Shimosato classification. Excluding 1 patient who died of an unknown cause 6 mo. after the end of the treatment and another of cerebral hemorrhage 7 mo. after the treatment, recurrence was noted 12 mo. after treatment in 1 of the remaining 9 patients; the other 8 have remained without any sign of recurrence for 2-25 mo. The adverse reactions noted during the treatment consisted of dermatitis in 3 and interstitial pneumonitis in 5 patients; the treatment was withdrawn from 5 of them. The interstitial pneumonitis was noted in the elderly patients aged 78 or more.

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Accession: 006079409



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