Effects of flutamide as a second‐line agent for maximum androgen blockade of hormone refractory prostate cancer

• Published in: International journal of urology Vol. 14; no. 3; pp. 264 - 267
• Main Authors: Nishimura, Kenji, Arichi, Naoko, Tokugawa, Shigeki, Yoshioka, Iwao, Kishikawa, Hidefumi, Ichikawa, Yasuji
• Format: Journal Article
• Language: English
• Published: Melbourne, Australia Blackwell Publishing Asia 01.03.2007
• Subjects: Aged; Androgen Antagonists - therapeutic use; Anilides - therapeutic use; Antineoplastic Agents, Hormonal - therapeutic use; bicalutamide; Biopsy, Needle; Drug Resistance, Neoplasm; Drug Therapy, Combination; Endosonography; flutamide; Flutamide - therapeutic use; Follow-Up Studies; Gonadotropin-Releasing Hormone - agonists; Goserelin - therapeutic use; hormone refractory prostate cancer; Humans; Leuprolide - therapeutic use; Magnetic Resonance Imaging; Male; maximum androgen blockade (MAB); Neoplasm Staging; Nitriles - therapeutic use; Prostate-Specific Antigen - blood; Prostatic Neoplasms - blood; Prostatic Neoplasms - diagnosis; Prostatic Neoplasms - drug therapy; Retrospective Studies; second‐line agent; Tomography, X-Ray Computed; Tosyl Compounds - therapeutic use; Treatment Outcome
• ISSN: 0919-8172; 1442-2042
• DOI: 10.1111/j.1442-2042.2007.01681.x

:  We analyzed clinical effects of flutamide as a second‐line agent for maximum androgen blockade (MAB) in patients with relapsing prostate cancer who received bicalutamide as the first‐line MAB agent. This study included 13 patients with progressive prostate cancer who had relapsed after first‐line MAB, with bicalutamide at 80 mg/day. After checking for antiandrogen withdrawal syndrome, they were given flutamide at 375 mg/day as second‐line MAB. The effectiveness of that therapy was evaluated by changes in prostatic specific antigen (PSA) levels, with response defined as a decrease of greater than 50% from the start of therapy. We also compared several factors between responders and non‐responders. Nine (69.2%) of the 13 patients showed a decrease in PSA levels, of whom five (38.5%) had a greater than 50% decrease and were defined as responders. The median duration of PSA response was 11.0 months (range 5–20 months). Patients who had a longer duration of response to first‐line MAB had a significantly greater response to second‐line MAB. For advanced prostate cancer patients who progressed on first‐line MAB with bicalutamide, flutamide administration as a second‐line antiandrogen was found to be relatively effective, especially for those who showed a longer duration of response to the first‐line MAB. Our results confirm previous findings that MAB using flutamide is an effective second‐line hormonal therapy.