Phase II Evaluation of Early Oral Estramustine, Oral Etoposide and Intravenous Paclitaxel in Combination With Hormone Therapy in Patients With High-Risk Metastatic Adenocarinoma of the Prostate

Inclusion Criteria

DISEASE CHARACTERISTICS:

- Histologically or cytologically confirmed high-risk adenocarcinoma of the prostate

- Clinical stage D2 disease as evidenced by one of the following:

- Visceral disease (liver, lung, or other viscera)

- Bone metastases to sites in both the axial (spine, pelvis, ribs, or skull)
and appendicular (claviculae, humeri, or femora) skeleton

- No prior or concurrent (treated or untreated) brain metastases

- Patients with clinical evidence of brain metastasis must have a negative brain
CT or MRI

- No evidence of untreated spinal cord compression

PATIENT CHARACTERISTICS:

Age:

- Over 18

Performance status:

- Zubrod 0-2

Life expectancy:

- Not specified

Hematopoietic:

- Absolute granulocyte count at least 1,500/mm^3

- Platelet count at least 100,000/mm^3

- No active hypercoagulability

Hepatic:

- Not specified

Renal:

- Not specified

Cardiovascular:

- No transient ischemic attacks, stroke, or myocardial infarction within the past 6
months

- No active coronary artery disease requiring antianginal therapy

- No active thrombophlebitis

Pulmonary:

- No history of pulmonary embolus

Other:

- No other prior malignancy within the past 5 years except adequately treated basal
cell or squamous cell skin cancer or adequately treated stage I or II cancer
currently in complete remission

PRIOR CONCURRENT THERAPY:

Biologic therapy:

- At least 4 weeks since prior biologic therapy and recovered

- No concurrent biologic therapy

Chemotherapy:

- No prior cytotoxic chemotherapy

- No other concurrent chemotherapy

Endocrine therapy:

- Prior androgen-blockade therapy (e.g., luteinizing hormone-releasing hormone agonist
and antiandrogen therapy) allowed if administered for a duration of less than 30 days

- Prior neoadjuvant hormonal therapy allowed

Radiotherapy:

- At least 4 weeks since prior radiotherapy and recovered

- No concurrent radiotherapy

Surgery:

- At least 4 weeks since prior surgery and recovered

Other:

- No concurrent bisphosphonates