Mitoxantrone associated with improvements in pain, pain impact, pain relief, insomnia, and global quality of life

[JimJimJimJim]

Jim Marshall (not a doctor) said ...

Mitoxantrone was the first chemotherapy approved by the FDA in the USA for castrate resistant prostate cancer.

It has been largely replaced by Taxotere (docetaxel) which has a clear survival advantage.

However, mitoxantrone may still be used for its pain relief and its other quality of life activity.

This paper below confirmed these quality of life benefits.

... end Jim

J Clin Oncol. 1999 Jun;17(6):1654-63.

Health-related quality of life in men with metastatic prostate cancer treated with prednisone alone or mitoxantrone and prednisone.

Osoba D, Tannock IF, Ernst DS, Neville AJ.

Source

Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada. david_osoba@bc.sympatico.ca

Abstract

PURPOSE:

A combination of mitoxantrone plus prednisone is preferable to prednisone alone for reduction of pain in men with metastatic, hormone-resistant, prostate cancer. The purpose of this study was to assess the effects of these treatments on health-related quality of life (HQL).

PATIENTS AND METHODS:

Men with metastatic prostate cancer (n = 161) were randomized to receive either daily prednisone alone or mitoxantrone (every 3 weeks) plus prednisone. Those who received prednisone alone could have mitoxantrone added after 6 weeks if there was no improvement in pain. HQL was assessed before treatment initiation and then every 3 weeks using the European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire C30 (EORTC QLQ-C30) and the Quality of Life Module-Prostate 14 (QOLM-P14), a trial-specific module developed for this study. An intent-to-treat analysis was used to determine the mean duration of HQL improvement and differences in improvement duration between groups of patients.

RESULTS:

At 6 weeks, both groups showed improvement in several HQL domains, and only physical functioning and pain were better in the mitoxantrone-plus-prednisone group than in the prednisone-alone group. After 6 weeks, patients taking prednisone showed no improvement in HQL scores, whereas those taking mitoxantrone plus prednisone showed significant improvements in global quality of life (P =.009), four functioning domains, and nine symptoms (.001 < P <. 01), and the improvement (> 10 units on a scale of 0 to100) lasted longer than in the prednisone-alone group (.004 < P <.05). The addition of mitoxantrone to prednisone after failure of prednisone alone was associated with improvements in pain, pain impact, pain relief, insomnia, and global quality of life (.001 < P <.003).

CONCLUSION:

Treatment with mitoxantrone plus prednisone was associated with greater and longer-lasting improvement in several HQL domains and symptoms than treatment with prednisone alone.

Comment in

J Clin Oncol. 1999 Jun;17(6):1651-3.

PMID: 10561201

[Mitoxantrone is sometimes spelt mitozantrone]

This extract can be found on http://PubMed.com, and is in the public domain.

On PubMed.com there will be a link to the full paper (often $30, sometimes free).

Any highlighting (except the title) is not by the author, but by Jim Marshall.

Jim is not a doctor.