Chemotherapy With or Without Biological Therapy in Treating Patients With Metastatic Prostate Cancer That Has Not Responded to Hormone Therapy

Inclusion Criteria

• •DISEASE CHARACTERISTICS:
• •Histologically confirmed adenocarcinoma of the prostate
• •Evidence of progressive metastatic disease (e.g., bone, pelvic mass, lymph node, liver or lung metastases)
• •* Radiologic evidence of hydronephrosis only does not constitute evidence of metastatic disease
• •Must not have an elevated serum alkaline phosphatase or PSA level as only evidence of disease
• •If bone metastases only (i.e., lacking soft tissue disease), must have PSA level of at least 20 ng/mL
• •If soft tissue metastases and/or visceral disease, must have either bidimensionally measurable disease or PSA level of at least 20 ng/mL
• •Must have had prior bilateral orchiectomy or other primary hormonal therapy (e.g., estrogen therapy or LHRH blocker plus flutamide) with evidence of treatment failure
• •No carcinomatous meningitis or brain metastases
• •PATIENT CHARACTERISTICS:
• •Age:
• •18 and over
• •Performance status:
• •ECOG 0-2
• •Life expectancy:
• •Not specified
• •Hematopoietic:
• •WBC at least 4,000/mm\^3
• •Granulocyte count at least 2,000/mm\^3
• •Platelet count at least 100,000/mm\^3
• •Hepatic:
• •See Disease Characteristics
• •Bilirubin no greater than 1.5 mg/dL
• •SGOT/SGPT no greater than 2 times upper limit of normal
• •Renal:
• •Creatinine no greater than 2.0 mg/dL OR
• •Creatinine clearance at least 50 mL/min
• •Cardiovascular:
• •No active angina pectoris
• •No New York Heart Association class III or IV heart disease
• •No myocardial infarction within the past 6 months
• •No deep venous thrombosis
• •LVEF at least 50% by MUGA
• •Other:
• •Fertile patients must use effective contraception during and for 1 month after study
• •Prior malignancy allowed provided curatively treated and disease free for appropriate time period for specific cancer
• •No other serious medical illness or active infection that would preclude protocol therapy
• •No concurrent prolonged exposure to sunlight
• •No concurrent alcohol consumption
• •PRIOR CONCURRENT THERAPY:
• •Biologic therapy:
• •Not specified
• •Chemotherapy:
• •No prior chemotherapy, including neoadjuvant chemotherapy or single-agent estramustine
• •Endocrine therapy:
• •See Disease Characteristics
• •If no prior bilateral orchiectomy, must continue LHRH agonist therapy (e.g., depot leuprolide or goserelin)
• •At least 4 weeks since prior flutamide or flutamide with evidence of progressive disease
• •At least 6 weeks since prior bicalutamide with evidence of progressive disease
• •Radiotherapy:
• •More than 4 weeks since prior radiotherapy
• •No prior strontium chloride Sr 89, samarium Sm 153 lexidronam pentasodium, or other radioisotope therapies
• •Surgery:
• •See Disease Characteristics
• •Other:
• •Recovered from all toxic effects due to prior treatment for prostate cancer
• •No concurrent milk, milk products, antacids, calcium-containing drugs, or any food with estramustine (arm I only)
• •No concurrent vitamin supplements containing vitamin A (arm II only)