OBJECTIVES:

• Determine the feasibility of administering docetaxel plus estramustine in combination with androgen deprivation therapy in patients with PSA elevation following radiotherapy or radical prostatectomy for early prostate cancer.
• Evaluate this regimen in terms of PSA response rate, response duration, and time to future therapeutic intervention in this patient population.
• Evaluate testosterone, free testosterone, and sex hormone binding globulin in relation to this treatment regimen in these patients.

OUTLINE: Patients receive oral estramustine three times a day on days 1-5 and docetaxel IV over 1 hour on day 2. Treatment repeats every 3 weeks for 4 courses.

Patients receive oral bicalutamide daily beginning on week 12 and leuprolide intramuscularly every 3 months beginning on week 13. Treatment continues for 15 months.

Patients are followed every 3 months for 2 years, every 4 months for 1 year, and every 6 months thereafter until disease progression.

PROJECTED ACCRUAL: Approximately 55 patients will be accrued for this study.

DISEASE CHARACTERISTICS:

• Histologically confirmed adenocarcinoma of the prostate

  • No metastases
• No measurable or evaluable disease

• 2 consecutively rising PSA levels at least 2 weeks apart, despite prior radical prostatectomy or radiotherapy (external beam or implant)

  • PSA risen to twice nadir value post radiotherapy

PATIENT CHARACTERISTICS:

Age:

• Not specified

Performance status:

• 0-1

Life expectancy:

• Not specified

Hematopoietic:

• Absolute neutrophil count at least 1,000/mm^3
• Platelet count at least 100,000/mm^3

Hepatic:

• Bilirubin no greater than upper limit of normal (ULN)

• Must meet 1 of the following criteria:

  • SGOT and/or SGPT no greater than 2.5 times ULN AND alkaline phosphatase no greater than ULN
  • Alkaline phosphatase no greater than 4.0 times ULN AND SGOT and/or SGPT no greater than ULN
  • SGOT and SGPT no greater than 1.5 times ULN AND alkaline phosphatase no greater than 2.5 times ULN

Renal:

• Not specified

Cardiovascular:

• At least 6 months since prior myocardial infarction, angina, or New York Heart Association class III or IV heart disease
• No active thrombophlebitis
• At least 6 months since prior thromboembolic events including deep vein thrombosis and cerebrovascular accident

Other:

• No other malignancies within the past 5 years except curatively treated basal cell skin cancer
• No active infection
• No significant neuropathy

PRIOR CONCURRENT THERAPY:

Biologic therapy:

• Not specified

Chemotherapy:

• No prior estramustine or suramin

Endocrine therapy:

• At least 6 months since prior neoadjuvant or adjuvant hormonal therapy of no greater than 6 months duration
• No concurrent corticosteroids

Radiotherapy:

• Salvage radiotherapy post prostatectomy allowed

Surgery:

• See Disease Characteristics