Mitoxantrone

Mitoxantrone, when used in combination with a corticosteroid, was found to be an effective palliative treatment for approximately 35 to 40% of patients with hormone-resistant advanced prostate cancer. It provided pain relief, decreased the need for analgesics, reduced PSA levels, and improved quality of life, but did not increase overall survival compared to corticosteroid alone. The drug was associated with neutropenia as the most common toxicity, but it had a more favorable tolerability profile than other cytotoxic agents like doxorubicin, especially in terms of acute adverse events and cardiac toxicity. The recommended dosage was 12 to 14 mg/m² every 21 days, with caution advised for patients with cardiac or hepatic issues. In studies involving 119 and 130 patients, cardiac dysfunction was observed in 13% and 4% of patients, respectively, and mild alopecia occurred in 24% of patients. Despite the lack of survival benefit, the combination of mitoxantrone and a corticosteroid was considered valuable for palliation in this patient group.