Low-Dose Chemotherapy with Insulin (Insulin Potentiation Therapy) in Combination with Hormone Therapy for Treatment of Castration-Resistant Prostate Cancer

Purpose. To evaluate the results and quality of life of patients with resistant of castration-resistant tumors previously treated with Insulin-potentiation therapy (IPT) combined with hormone therapy. Materials and methods. Sixteen patients with metastasis prostate tumors after bilateral castration, androgenic blockade, and progression of the disease were observed during the study. The patients were divided into two groups: group A consisting of 8 patients treated with low-dose chemotherapy Epirubicin, Vinblastine, and Cyclophosphamide combined with LHRH agonist and group B consisting of another 8 patients treated with low-dose chemotherapy Docetaxel combined with LHRH agonist. Results. The overall (groups A and B) results concerning PSA after the sixth IPT show partial effect in 8 out of 16 (50%) patients, stabilization in 4 out of 16 (25%), and progression in 4 out of 16 (25%). The median survival for all treated patients is 11,7 months (range 3–30 months). During the treatment no significant side effects were observed, and no lethal cases occurred. Conclusion. In spite of the small number of the treated patients with castration-resistant prostate tumors, the preliminary results are promising and this gives us hope and expectations for future serious multicenter research over the possibilities for routine implementation of IPTLD. 1. Introduction In spite of the efficacy of standard androgen deprivation therapy for metastasis tumors of prostate gland, almost all of the patients progress with their disease. In the last few years the prostate tumors progress although the androgen blockade is defined as castration-resistant prostate cancer—CRPC [1, 2]. Despite obvious efforts for revealing the reasons for hormonal resistance after androgen deprivation, the treatment remains a challenge. The duration of remission after treatment of hormone-resistant tumors of prostate gland with secondary hormonal manipulation is short and there is no serious impact on survival [3]. Up to 1990 the results after chemotherapy for hormone-resistant tumors of prostate gland are disappointing. Later a Canadian researcher drew our attention to the potentialities of the combination Mitoxantrone with Prednisone where an improvement in pain and quality of life was indicated but there was no effect on the survival [3, 4]. In 2004 two trials registered and prolonged survival after using Docetaxel. The overall survival with Docetaxel was 18,9 months against 16,5 months with Mitoxantrone and Prednisolone. There were registered improvements also in toxicity and quality of life. At this