# Estramustine

Source: https://onco.cc/drugs/estramustine/  
OnCo record `estramustine` (Treatment). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Estramustine is an oral prostate cancer drug that combines an oestrogen with an alkylating agent, approved in the United States in 1981 for metastatic disease and later combined with taxanes, though its clotting risk has pushed it out of routine use.

## Summary

Estramustine phosphate was designed to deliver a nitrogen mustard to oestrogen-receptor-bearing prostate cancer cells, but it turned out to work mostly by disrupting microtubules. The FDA approved it in 1981 for palliative treatment of metastatic or progressive prostate cancer. In the 1990s and 2000s it was combined with docetaxel and other taxanes with higher response rates than the taxane alone, but venous thromboembolism and the equal survival of docetaxel alone in the TAX 327 era left it out of standard regimens. It remains licensed in the United States and Europe.

## Fields

- Kind: Treatment
- Status: established
- Last checked: 2026-09-08
- Also known as: Estramustine phosphate
- Tags: gap-fill; chembl-universe
- Brand: Emcyt
- Modality: Oral oestradiol and nitrogen mustard conjugate
- Mechanism: Carries a nornitrogen mustard on an oestradiol backbone; in the body it acts mainly as an antimicrotubule agent that binds microtubule-associated proteins, with oestrogenic effects that also lower testosterone.
- Approvals: US 1981: Palliative treatment of metastatic or progressive prostate cancer

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Estramustine
- Label (DailyMed): https://dailymed.nlm.nih.gov/dailymed/search.cfm?labeltype=all&query=estramustine
- Wikipedia: https://en.wikipedia.org/wiki/Estramustine
- ChEMBL CHEMBL1201078: https://www.ebi.ac.uk/chembl/explore/compound/CHEMBL1201078

## Connected records

- cancers: [Prostate cancer](https://onco.cc/cancers/prostate/)
- technologies: [Cytotoxic chemotherapy](https://onco.cc/technologies/cytotoxic-chemotherapy/)
- targets: [Tubulin (microtubules)](https://onco.cc/targets/tubulin/)
- drugs: [Docetaxel](https://onco.cc/drugs/docetaxel/)
- companies: [Pfizer (incl. Seagen)](https://onco.cc/companies/pfizer/)
- trials: [Chemotherapy With or Without Strontium-89 in Treating Patients With Prostate Cancer](https://onco.cc/trials/nct00024167/), [Hormone Therapy Plus Radiation Therapy With or Without Combination Chemotherapy in Treating Patients With Prostate Cancer](https://onco.cc/trials/nct00004054/), [Hormone Therapy With or Without Docetaxel And Estramustine in Treating Patients With Prostate Cancer That is Locally Advanced or At High Risk of Relapse](https://onco.cc/trials/nct00055731/), [SWOG 9916](https://onco.cc/trials/swog-9916/)
- key papers: [SWOG 9916: docetaxel and estramustine compared with mitoxantrone and prednisone for advanced refractory prostate cancer](https://onco.cc/key-papers/paper-petrylak-swog-9916-docetaxel-estramustine-nejm-2004/)

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