Bicalutamide 150 Mg Maintains Bone Mineral Density During Monotherapy for Localized or Locally Advanced Prostate Cancer

Abstract

Bicalutamide 150 mg monotherapy may offer an important advantage compared to castration in terms of bone loss and body composition for patients who require long-term androgen deprivation for localized or locally advanced prostate cancer.

The effect of androgen deprivation therapy on body composition in men with prostate cancer: Systematic review and meta-analysis

“…Six studies [17,22,[26][27][28]30], involving 260 patients and with treatment periods ranging from 3 to 24 months, reported the % change in percentage of lean mass ( Table 2). Loss of lean mass was reported in all of the studies and the pooled estimate was −2.8% (95% CI, −3.6% to −2.0%, P< 0.00001) (Fig.…”

“…Sixteen longitudinal studies were included in the systematic review, 14 cohort studies [7,16,[18][19][20][21][22][23][24][25][26][27][28][29] and two RCTs [17,30]. Both RCTs were the continuation phase of a randomized design comparing the efficacy of two types of hormone therapy (LHRH analogue vs. anti-androgen).…”

Bicalutamide (‘Casodex’) 150 mg in addition to standard care in patients with nonmetastatic prostate cancer: updated results from a randomised double-blind phase III study (median follow-up 5.1 y) in the early prostate cancer programme

“…16 Furthermore, long-term therapy is associated with loss of bone mineral density, which can lead to osteoporotic fractures. [17][18][19] Data from two open-label, multicentre studies (studies 306 and 307), which were prospectively designed for pooled analysis, have demonstrated that in patients with locally advanced prostate cancer requiring immediate hormonal therapy, bicalutamide is similar to castration in terms of objective PFS and overall survival. 16 Studies 306 and 307 also demonstrated significant advantages in favour of bicalutamide in terms of maintaining sexual interest and physical capacity.…”

“…16 Other randomised trials indicate that in contrast to castration, bicalutamide preserves bone mineral density. 18,19 In Trial 24, bicalutamide was associated with low incidences of decreased libido, impotence and hot flushes. The most common adverse events of bicalutamide treatment in Trial 24 were gynaecomastia and breast pain, which were of mild to moderate intensity in the majority of cases.…”

Case study: management of advanced prostate cancer with soft tissue metastases

“…Nonsteroidal antiandrogens have an improved side-effect profile compared with castrationbased therapy, particularly in terms of maintaining sexual interest and physical capacity and avoiding loss of bone mineral density. 7,8 However, these benefits in favor of nonsteroidal antiandrogen monotherapy need to be balanced against the available comparative efficacy data from randomized trials in patients with metastatic disease, which show mixed results. 9 It should be noted that there are currently no randomized trial data on the use of any hormonal therapies in patients with rising PSA.…”