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Erschienen in: International Urology and Nephrology 3/2015

01.03.2015 | Urology - Original Paper

Bicalutamide 150 mg as secondary hormonal therapy for castration-resistant prostate cancer

verfasst von: Su-bo Qian, Hai-bo Shen, Qi-feng Cao, Lin Zhang, Yi-fan Chen, Jun Qi

Erschienen in: International Urology and Nephrology | Ausgabe 3/2015

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Abstract

Purpose

This study was aimed to evaluate the effect and tolerability of bicalutamide 150 mg therapy in patients with castration-resistant prostate cancer (CRPC).

Methods

A total of 48 patients with histologically confirmed prostate cancer were included. They had been treated with continuous maximal androgen blockade therapy, but their serum prostate-specific antigen (PSA) increased after initial hormonal therapy. Patients were given bicalutamide (150 mg per day). Serum PSA testing was performed every 3 months. The response was defined according to PSA decline from baseline: PSA decline ≥85 % as complete response, ≥50 % but <85 % as partial response, and <50 % as failure. Response duration was defined as the time from PSA response until PSA increased ≥25 % or ≥2 ng/mL from the nadir. The potential predictive factors (Gleason score, clinical stage and serum PSA) were investigated.

Results

The time of follow-up was 3–30 months. A PSA decline ≥50 % was observed in 37 of 48 patients including 18 ≥ 50 % but <85 % and 19 ≥ 85 % responders. The median response duration was 12 months for partial responders and 20 months for complete responders. Patients with lower Gleason score, lower serum PSA and using flutamide as first-line nonsteroidal antiandrogen achieved more benefits. Moreover, bicalutamide 150 mg therapy was well tolerated.

Conclusions

Bicalutamide 150 mg therapy was an appropriate therapeutic method for patients of CRPC, especially for those with lower Gleason score, lower serum PSA and using flutamide as first-line nonsteroidal antiandrogen.
Literatur
1.
2.
Zurück zum Zitat Lodde M, Lacombe L, Fradet Y (2010) Salvage therapy with bicalutamide 150 mg in nonmetastatic castration-resistant prostate cancer. Urology 76:1189–1193CrossRefPubMed Lodde M, Lacombe L, Fradet Y (2010) Salvage therapy with bicalutamide 150 mg in nonmetastatic castration-resistant prostate cancer. Urology 76:1189–1193CrossRefPubMed
3.
Zurück zum Zitat Suzuki H, Okihara K, Miyake H et al (2008) Alternative nonsteroidal antiandrogen therapy for advanced prostate cancer that relapsed after initial maximum androgen blockade. J Urol 180:921–927CrossRefPubMed Suzuki H, Okihara K, Miyake H et al (2008) Alternative nonsteroidal antiandrogen therapy for advanced prostate cancer that relapsed after initial maximum androgen blockade. J Urol 180:921–927CrossRefPubMed
4.
Zurück zum Zitat Tanimoto T, Hori A, Kami M (2010) Sipuleucel-T immunotherapy for castration-resistant prostate cancer. N Engl J Med 363:1966CrossRefPubMed Tanimoto T, Hori A, Kami M (2010) Sipuleucel-T immunotherapy for castration-resistant prostate cancer. N Engl J Med 363:1966CrossRefPubMed
5.
Zurück zum Zitat Locke JA, Nelson CC, Adomat HH, Hendy SC, Gleave ME, Guns EST (2009) Steroidogenesis inhibitors alter but do not eliminate androgen synthesis mechanisms during progression to castration-resistance in LNCaP prostate xenografts. J Steroid Biochem Mol Biol 115:126–136CrossRefPubMed Locke JA, Nelson CC, Adomat HH, Hendy SC, Gleave ME, Guns EST (2009) Steroidogenesis inhibitors alter but do not eliminate androgen synthesis mechanisms during progression to castration-resistance in LNCaP prostate xenografts. J Steroid Biochem Mol Biol 115:126–136CrossRefPubMed
6.
Zurück zum Zitat Stanbrough M, Bubley GJ, Ross K et al (2006) Increased expression of genes converting adrenal androgens to testosterone in androgen-independent prostate cancer. Cancer Res 66:2815–2825CrossRefPubMed Stanbrough M, Bubley GJ, Ross K et al (2006) Increased expression of genes converting adrenal androgens to testosterone in androgen-independent prostate cancer. Cancer Res 66:2815–2825CrossRefPubMed
7.
Zurück zum Zitat Mohler JL (2008) Castration-recurrent prostate cancer is not androgen-independent, in hormonal carcinogenesis V. Springer, NewYork, pp 223–234 Mohler JL (2008) Castration-recurrent prostate cancer is not androgen-independent, in hormonal carcinogenesis V. Springer, NewYork, pp 223–234
8.
Zurück zum Zitat Small EJ, Vogelzang NJ (1997) Second-line hormonal therapy for advanced prostate cancer: a shifting paradigm. J Clin Oncol 15:382–388PubMed Small EJ, Vogelzang NJ (1997) Second-line hormonal therapy for advanced prostate cancer: a shifting paradigm. J Clin Oncol 15:382–388PubMed
9.
Zurück zum Zitat Klotz L, Drachenberg D, Singal R et al (2014) An open-label, phase 2 trial of bicalutamide dose escalation from 50 to 150 mg in men with CAB and castration resistance. A Canadian urology research consortium study. Prostate Cancer Prostatic Dis 17:320–324CrossRefPubMed Klotz L, Drachenberg D, Singal R et al (2014) An open-label, phase 2 trial of bicalutamide dose escalation from 50 to 150 mg in men with CAB and castration resistance. A Canadian urology research consortium study. Prostate Cancer Prostatic Dis 17:320–324CrossRefPubMed
10.
Zurück zum Zitat Nakabayashi M, Werner L, Oh WK, Regan MM, Kantoff PW, Taplin M-E (2011) Secondary hormonal therapy in men with castration-resistant prostate cancer. Clin Genitourin Cancer 9:95–103CrossRefPubMed Nakabayashi M, Werner L, Oh WK, Regan MM, Kantoff PW, Taplin M-E (2011) Secondary hormonal therapy in men with castration-resistant prostate cancer. Clin Genitourin Cancer 9:95–103CrossRefPubMed
11.
Zurück zum Zitat Labrie F (2014) Prostate cancer: bicalutamide dose increase in castration-resistant disease. Nat Rev Urol Labrie F (2014) Prostate cancer: bicalutamide dose increase in castration-resistant disease. Nat Rev Urol
12.
Zurück zum Zitat Kucuk O, Fisher E, Moinpour CM et al (2001) Phase II trial of bicalutamide in patients with advanced prostate cancer in whom conventional hormonal therapy failed: a Southwest oncology group study (SWOG 9235). Urology 58:53–58CrossRefPubMed Kucuk O, Fisher E, Moinpour CM et al (2001) Phase II trial of bicalutamide in patients with advanced prostate cancer in whom conventional hormonal therapy failed: a Southwest oncology group study (SWOG 9235). Urology 58:53–58CrossRefPubMed
13.
Zurück zum Zitat Yates JW, Chalmer B, Mckegney FP (1980) Evaluation of patients with advanced cancer using the Karnofsky performance status. Cancer 45:2220–2224CrossRefPubMed Yates JW, Chalmer B, Mckegney FP (1980) Evaluation of patients with advanced cancer using the Karnofsky performance status. Cancer 45:2220–2224CrossRefPubMed
14.
15.
Zurück zum Zitat Attard G, Richards J, De Bono JS (2011) New strategies in metastatic prostate cancer: targeting the androgen receptor signaling pathway. Clin Cancer Res 17:1649–1657CrossRefPubMedCentralPubMed Attard G, Richards J, De Bono JS (2011) New strategies in metastatic prostate cancer: targeting the androgen receptor signaling pathway. Clin Cancer Res 17:1649–1657CrossRefPubMedCentralPubMed
16.
Zurück zum Zitat Ferraldeschi R, Pezaro C, Karavasilis V, De Bono J (2013) Abiraterone and novel antiandrogens: overcoming castration resistance in prostate cancer. Annu Rev Med 64:1–13CrossRefPubMed Ferraldeschi R, Pezaro C, Karavasilis V, De Bono J (2013) Abiraterone and novel antiandrogens: overcoming castration resistance in prostate cancer. Annu Rev Med 64:1–13CrossRefPubMed
17.
Zurück zum Zitat Ahmed A, Ali S, Sarkar FH (2014) Advances in androgen receptor targeted therapy for prostate cancer. J Cell Physiol 229:271–276CrossRefPubMed Ahmed A, Ali S, Sarkar FH (2014) Advances in androgen receptor targeted therapy for prostate cancer. J Cell Physiol 229:271–276CrossRefPubMed
18.
Zurück zum Zitat Taplin M-E, Bubley GJ, Shuster TD et al (1995) Mutation of the androgen-receptor gene in metastatic androgen-independent prostate cancer. N Engl J Med 332:1393–1398CrossRefPubMed Taplin M-E, Bubley GJ, Shuster TD et al (1995) Mutation of the androgen-receptor gene in metastatic androgen-independent prostate cancer. N Engl J Med 332:1393–1398CrossRefPubMed
19.
Zurück zum Zitat Guerrero J, Alfaro IE, Gómez F, Protter AA, Bernales S (2013) Enzalutamide, an androgen receptor signaling inhibitor, induces tumor regression in a mouse model of castration-resistant prostate cancer. Prostate 73:1291–1305CrossRefPubMed Guerrero J, Alfaro IE, Gómez F, Protter AA, Bernales S (2013) Enzalutamide, an androgen receptor signaling inhibitor, induces tumor regression in a mouse model of castration-resistant prostate cancer. Prostate 73:1291–1305CrossRefPubMed
20.
Zurück zum Zitat Chen Y, Clegg NJ, Scher HI (2009) Anti-androgens and androgen-depleting therapies in prostate cancer: new agents for an established target. Lancet Oncol 10:981–991CrossRefPubMedCentralPubMed Chen Y, Clegg NJ, Scher HI (2009) Anti-androgens and androgen-depleting therapies in prostate cancer: new agents for an established target. Lancet Oncol 10:981–991CrossRefPubMedCentralPubMed
21.
Zurück zum Zitat Schellhammer PF, Venner P, Haas GP et al (1997) Prostate specific antigen decreases after withdrawal of antiandrogen therapy with bicalutamide or flutamide in patients receiving combined androgen blockade. J Urol 157:1731–1735CrossRefPubMed Schellhammer PF, Venner P, Haas GP et al (1997) Prostate specific antigen decreases after withdrawal of antiandrogen therapy with bicalutamide or flutamide in patients receiving combined androgen blockade. J Urol 157:1731–1735CrossRefPubMed
22.
Zurück zum Zitat Small EJ, Halabi S, Dawson NA et al (2004) Antiandrogen withdrawal alone or in combination with ketoconazole in androgen-independent prostate cancer patients: a phase III trial (CALGB 9583). J Clin Oncol 22:1025–1033CrossRefPubMed Small EJ, Halabi S, Dawson NA et al (2004) Antiandrogen withdrawal alone or in combination with ketoconazole in androgen-independent prostate cancer patients: a phase III trial (CALGB 9583). J Clin Oncol 22:1025–1033CrossRefPubMed
23.
Zurück zum Zitat Figg WD, Sartor O, Cooper MR et al (1995) Prostate specific antigen decline following the discontinuation of flutamide in patients with stage D2 prostate cancer. Am J Med 98:412–414CrossRefPubMed Figg WD, Sartor O, Cooper MR et al (1995) Prostate specific antigen decline following the discontinuation of flutamide in patients with stage D2 prostate cancer. Am J Med 98:412–414CrossRefPubMed
24.
Zurück zum Zitat Scher HI, Liebertz C, Kelly WK et al (1997) Bicalutamide for advanced prostate cancer: the natural versus treated history of disease. J Clin Oncol 15:2928–2938PubMed Scher HI, Liebertz C, Kelly WK et al (1997) Bicalutamide for advanced prostate cancer: the natural versus treated history of disease. J Clin Oncol 15:2928–2938PubMed
25.
Zurück zum Zitat Joyce R, Fenton MA, Rode P et al (1998) High dose bicalutamide for androgen independent prostate cancer: effect of prior hormonal therapy. J Urol 159:149–153CrossRefPubMed Joyce R, Fenton MA, Rode P et al (1998) High dose bicalutamide for androgen independent prostate cancer: effect of prior hormonal therapy. J Urol 159:149–153CrossRefPubMed
26.
Zurück zum Zitat Ryan CJ, Small EJ (2003) Role of secondary hormonal therapy in the management of recurrent prostate cancer. Urology 62:87–94CrossRefPubMed Ryan CJ, Small EJ (2003) Role of secondary hormonal therapy in the management of recurrent prostate cancer. Urology 62:87–94CrossRefPubMed
27.
Zurück zum Zitat Hara T, Miyazaki J-I, Araki H et al (2003) Novel mutations of androgen receptor A possible mechanism of bicalutamide withdrawal syndrome. Cancer Res 63:149–153PubMed Hara T, Miyazaki J-I, Araki H et al (2003) Novel mutations of androgen receptor A possible mechanism of bicalutamide withdrawal syndrome. Cancer Res 63:149–153PubMed
28.
Zurück zum Zitat Taplin M-E, Bubley GJ, Ko Y-J et al (1999) Selection for androgen receptor mutations in prostate cancers treated with androgen antagonist. Cancer Res 59:2511–2515PubMed Taplin M-E, Bubley GJ, Ko Y-J et al (1999) Selection for androgen receptor mutations in prostate cancers treated with androgen antagonist. Cancer Res 59:2511–2515PubMed
29.
Zurück zum Zitat Hu X, Lazar MA (2000) Transcriptional repression by nuclear hormone receptors. Trends Endocrinol Metab 11:6–10CrossRefPubMed Hu X, Lazar MA (2000) Transcriptional repression by nuclear hormone receptors. Trends Endocrinol Metab 11:6–10CrossRefPubMed
30.
Zurück zum Zitat Narimoto K, Mizokami A, Izumi K et al (2010) Adrenal androgen levels as predictors of outcome in castration-resistant prostate cancer patients treated with combined androgen blockade using flutamide as a second-line anti-androgen. Int J Urol 17:337–345CrossRefPubMed Narimoto K, Mizokami A, Izumi K et al (2010) Adrenal androgen levels as predictors of outcome in castration-resistant prostate cancer patients treated with combined androgen blockade using flutamide as a second-line anti-androgen. Int J Urol 17:337–345CrossRefPubMed
31.
Zurück zum Zitat Kim J, Jia L, Stallcup M, Coetzee G (2005) The role of protein kinase A pathway and cAMP responsive element-binding protein in androgen receptor-mediated transcription at the prostate-specific antigen locus. J Mol Endocrinol 34:107–118CrossRefPubMed Kim J, Jia L, Stallcup M, Coetzee G (2005) The role of protein kinase A pathway and cAMP responsive element-binding protein in androgen receptor-mediated transcription at the prostate-specific antigen locus. J Mol Endocrinol 34:107–118CrossRefPubMed
32.
Zurück zum Zitat Yu G, Traish AM (2011) Induced testosterone deficiency: from clinical presentation of fatigue, erectile dysfunction and muscle atrophy to insulin resistance and diabetes. Horm Mol Biol Clin Investig 8:425–430 Yu G, Traish AM (2011) Induced testosterone deficiency: from clinical presentation of fatigue, erectile dysfunction and muscle atrophy to insulin resistance and diabetes. Horm Mol Biol Clin Investig 8:425–430
33.
Zurück zum Zitat Lam JS, Leppert JT, Vemulapalli SN, Shvarts O, Belldegrun AS (2006) Secondary hormonal therapy for advanced prostate cancer. J Urol 175:27–34CrossRefPubMed Lam JS, Leppert JT, Vemulapalli SN, Shvarts O, Belldegrun AS (2006) Secondary hormonal therapy for advanced prostate cancer. J Urol 175:27–34CrossRefPubMed
Metadaten
Titel
Bicalutamide 150 mg as secondary hormonal therapy for castration-resistant prostate cancer
verfasst von
Su-bo Qian
Hai-bo Shen
Qi-feng Cao
Lin Zhang
Yi-fan Chen
Jun Qi
Publikationsdatum
01.03.2015
Verlag
Springer Netherlands
Erschienen in
International Urology and Nephrology / Ausgabe 3/2015
Print ISSN: 0301-1623
Elektronische ISSN: 1573-2584
DOI
https://doi.org/10.1007/s11255-015-0919-y

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