Hormone Therapy Compared With Combination Chemotherapy in Treating Patients With Prostate Cancer

DISEASE CHARACTERISTICS:

• Histologically confirmed adenocarcinoma of the prostate that was continuously treated with androgen suppression
• Rising prostate-specific antigen (PSA), defined as PSA > 5 ng/mL, rising on 2 consecutive measurements at least 4 weeks apart
• Gleason score 7 or higher and/or seminal vesicle involvement at diagnosis

• Patients previously treated with antiandrogen or glucocorticoid therapy must meet the following criteria:

  • Must show a continued rise in PSA after stopping antiandrogen (flutamide, bicalutamide, or nilutamide) or glucocorticoid (dexamethasone or prednisone)

    • At least 4 weeks continued rise in PSA after flutamide or nilutamide (6 weeks for bicalutamide)

• Testosterone less than 50 ng/dL

  • Patients who have not undergone surgical castration must continue primary androgen suppression to maintain castrate levels of testosterone
• No progressive or measurable local or metastatic disease (including bone metastases)

PATIENT CHARACTERISTICS:

Age:

• 18 and over

Performance status:

• ECOG 0-1

Life expectancy:

• Not specified

Hematopoietic:

• Granulocyte count at least 2,000/mm^3
• Platelet count at least 100,000/mm^3

Hepatic:

• SGOT no greater than 2 times upper limit of normal
• Bilirubin no greater than 1.5 mg/dL

Renal:

• Creatinine no greater than 1.7 mg/dL

Cardiovascular:

• No American Heart Association class III or IV heart disease
• No uncontrolled congestive heart failure
• No life-threatening cardiac arrhythmias

Other:

• Fertile patients must use effective contraception
• No other prior malignancy unless curatively treated and disease-free for appropriate time period for specific cancer
• No preexisting peripheral neuropathy greater than grade 1
• No known hypersensitivity to polysorbate 80

PRIOR CONCURRENT THERAPY:

Biologic therapy:

• Not specified

Chemotherapy:

• At least 5 years since prior systemic chemotherapy

Endocrine therapy:

• See Disease Characteristics
• At least 4 weeks since prior hydrocortisone
• No prior ketoconazole

Radiotherapy:

• At least 28 days since prior radiotherapy to primary site
• No prior palliative radiotherapy
• No concurrent radiotherapy

Surgery:

• See Disease Characteristics

Other:

• Recovered form prior therapy
• At least 7 days since prior parenteral antibiotics for active infection
• No concurrent digitalis
• No concurrent H_2 blockers or proton pump inhibitors (arm I only)
• Concurrent bisphosphonates allowed provided they were initiated prior to study therapy