Bicalutamide as Immediate Therapy Either Alone or as Adjuvant to Standard Care of Patients with Localized or Locally Advanced Prostate Cancer: First Analysis of the Early Prostate Cancer Program

See, William A.; Wirth, Manfred P.; McLeod, David G.; Iversen, Peter; Klimberg, Ira; Gleason, Donald M.; Chodak, Gerald W.; Montie, James E.; Tyrrell, C.J.; Wallace, D. M. A.; Delaere, K.P.J.; Vaage, Sigmund; Tammela, Teuvo L.J.; Lukkarinen, O; Persson, Bo‐Eric; Carroll, Kevin; Kolvenbag, Geert J.C.M.

doi:10.1016/s0022-5347(05)64652-6

Cited by 208 publications

(121 citation statements)

References 13 publications

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“…Many clinical studies suggest that early androgen ablation may offer a survival benefit in patients with advanced prostate cancer and may prolong the time to the development of androgen-independent prostate cancer [24][25][26]. Other studies indicate that early castration offers no survival advantage and might not be needed [27,28].…”

Section: Discussionmentioning

confidence: 99%

Early and delayed castrations confer a similar survival advantage in TRAMP mice

Zhang¹,

Xu²,

Huang³

et al. 2009

Asian J Androl

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The most appropriate time to introduce androgen deprivation therapy for prostate cancer remains controversial. Our aim was to evaluate the effects of early versus delayed surgical castration on prostate cancer progression and survival in the transgenic adenocarcinoma of the mouse prostate (TRAMP) model. TRAMP mice were randomly divided into three groups: the early castration group (on which castration was performed at the age of 4 weeks), the delayed castration group (on which castration was performed when abdominal tumours could be palpated), and the sham-castrated group. Mice were monitored daily throughout their lives until cancer-related death or the development of an obviously moribund appearance, at which time the individual mouse was killed. Androgen receptor expression in prostate tumours was also evaluated. The results shows that the average lifespan in early castration, delayed castration and sham-castrated groups were 54.1 weeks, 59.9 weeks and 39.1 weeks, respectively. Both early castration and delayed castration conferred a statistically significant survival advantage when compared with the sham-castrated group (P < 0.001). However, the difference in lifespan between the early castration group and the delayed castration group was not statistically significant (P = 0.85). The increase in lifespan in the TRAMP mice that received either early or delayed castration correlated with lower G/B value (genitourinary tract weight/body weight) at death than the sham-castrated mice. In conclusion, early and delayed castrations in TRAMP mice prolonged survival to a similar extent. This finding may provide a guide for clinical practice in prostate cancer therapy.

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Section: Discussionmentioning

confidence: 99%

Early and delayed castrations confer a similar survival advantage in TRAMP mice

Zhang¹,

Xu²,

Huang³

et al. 2009

Asian J Androl

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“…However, disease progression is present in more than 70% of the patients who receive bicalutamide monotherapy 49 and more than 30% of patients who receive combined therapy. 51 These studies suggest that there is a pathway(s) other than AR transactivation responsible for disease progression, or that there are hormonally independent cells in the diseased prostate. In the presence of androgen blockades, the AR is not downregulated, 52,53 and adrenal androgens, AR, and other steroid receptors may stimulate mitogenic growth factor signaling pathways to mediate cellular proliferation.…”

Section: Discussionmentioning

confidence: 99%

5α-Androstane-3α,17β-diol activates pathway that resembles the epidermal growth factor responsive pathways in stimulating human prostate cancer LNCaP cell proliferation

Zimmerman

Dozmorov

Nunlist

et al. 2004

Prostate Cancer Prostatic Dis

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5a-Androstane-3a,17b-diol (3a-diol) is considered to have no androgenic effects in androgen target organs unless it is oxidized to 5a-dihydrotestosterone (5a-DHT). We used microarray and bioinformatics to identify and compare 3a-diol and 5a-DHT responsive gene in human prostate LNCaP cells. Through a procedure called 'hypervariable determination', a similar set of 30 responsive genes involving signal transduction, transcription regulation, and cell proliferation were selected in 5a-DHT-, 3a-diol-, and epidermal growth factor (EGF)-treated samples. F-means cluster and networking procedures showed that the responsive pattern of these genes was more closely related between 3a-diol and EGF than between 5a-DHT and 3a-diol treatments. We conclude that 3a-diol is capable of stimulating prostate cell proliferation by eliciting EGF-like pathway in conjunction with androgen receptor pathway.

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“…14 Immediate treatment with the non-steroidal antiandrogen, bicalutamide 150 mg, either alone or as adjuvant to radical prostatectomy or radiotherapy, significantly reduced the risk of objective disease progression irrespective of disease stage (localized or locally advanced) 15 or prior therapy (radical prostatectomy, radiotherapy, or watchful waiting). 16 The trial program is ongoing and further data are awaited.…”

Section: Management Of Localized Prostate Cancer: the Current Situationmentioning

confidence: 98%

“…Data from the bicalutamide EPC program demonstrate that immediate treatment with bicalutamide 150 mg significantly reduces the risk of objective disease progression in patients who would have otherwise undergone watchful waiting. 14,16 …”

Section: Management Of Localized Prostate Cancer: the Current Situationmentioning

confidence: 99%

The management of localized prostate cancer

Dawson

Fourcade²,

Newling

2002

Prostate Cancer Prostatic Dis

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At this point in time, the only possibility of curing prostate cancer is through the early detection and treatment of localized disease. The large number of treatment options available for localized prostate cancer, including radical prostatectomy, radiotherapy (either external beam or interstitial), hormone therapy and watchful waiting, can be confusing for the patient. These treatments are associated with different adverse effects, further complicating the treatment decision. As there will inevitably be a trade-off between expected cure and acceptable adverse effects, it is important to discuss all options with the patient. The doctor and patient must together decide the appropriate treatment for him and his tumor.

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Bicalutamide as Immediate Therapy Either Alone or as Adjuvant to Standard Care of Patients with Localized or Locally Advanced Prostate Cancer: First Analysis of the Early Prostate Cancer Program

Cited by 208 publications

References 13 publications

Early and delayed castrations confer a similar survival advantage in TRAMP mice

Early and delayed castrations confer a similar survival advantage in TRAMP mice

5α-Androstane-3α,17β-diol activates pathway that resembles the epidermal growth factor responsive pathways in stimulating human prostate cancer LNCaP cell proliferation

The management of localized prostate cancer

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