Hormonal Therapy and Chemotherapy Followed by Prostatectomy in Patients With Prostate Cancer

Exclusion Criteria

• •Prostatic adenocarcinoma with neuroendocrine differentiation or small cell features
• •Surgical resection or major surgery within 4 weeks or stereotactic biopsy within 1 week of first ADT and chemotherapy treatment
• •Previous or current hormonal treatment, chemotherapy, radiation therapy, immunotherapy, or investigational study drug.
• •Unable to tolerate multiparametric MRI or is contraindicated.
• •Patients not appropriate surgical candidates for radical prostatectomy based on the evaluation of coexistent medical diseases and competing causes of death.
• •Patients with uncontrolled cardiac, hepatic, renal, or neurologic/psychiatric disorder.
• •Severe gastrointestinal bleeding within 12 weeks of treatment with ADT and chemotherapy
• •Patients who are HIV positive or have chronic hepatitis B or C infections.
• •Congestive heart failure New York Heart Association (NYHA) class 3 or 4, or history of congestive heart failure New York Heart Association (NYHA) class 3 or 4, unless a 2D echocardiogram or multi-gated acquisition scan (MUGA) performed within 3 months of enrollment demonstrates a left ventricular ejection fraction \>45%.
• •Sensory neuropathy grade \>1.
• •History of another malignancy within the previous 5 years other than curatively treated non-melanoma skin cancer.
• •Use of herbal products that may decrease PSA levels (e.g., saw palmetto) or systemic corticosteroids greater than the equivalent of 10 mg of prednisone per day within 4 weeks of enrollment.
• •Any other condition, including concurrent medical condition, social circumstance or drug dependency, which in the opinion of the investigator could compromise patient safety and/or compliance with study requirements