Prolonged Response to Nilutamide in a Patient with Stage D0.5 Prostate Cancer Who Previously Failed Androgen Deprivation Therapy

Abstract

There is currently no standard therapy for patients with prostate cancer who have progressive rise in PSA levels despite treatment with hormonal ablation and antiandrogen withdrawal (stage D0.5). One potential treatment option is the use of a different androgen receptor antagonist (ARA), such as nilutamide. We report a case of a 66-year-old gentleman with greater than a 46 month sustained response to nilutamide therapy after failing bicalutamide therapy and its subsequent withdrawal. The patient continues to have undetectable PSA levels and an excellent performance status. This case demonstrates the prolonged response to a second-line ARA in patients deemed to have androgen insensitive prostate cancer. Further investigation of the potential role of nilutamide therapy as second-line antiandrogen therapy is warranted as monotherapy and/or in combination with other promising novel approaches including PSA-based vaccines.

Sorafenib Has Potent Antitumor Activity against Multiple Myeloma In Vitro, Ex Vivo, and In Vivo in the 5T33MM Mouse Model

“…This has been previously shown for renal cell carcinoma and hepatocellular carcinoma where the antiangiogenic effects of sorafenib were found to be partly responsible for the potent antitumor activity observed in the clinic (32,33). In the multiple myeloma setting, we found that sorafenib significantly decreased MVD in the bone marrow of multiple myeloma mice and indicating that the antitumoral effects of sorafenib may, at least in part, be mediated by inhibition of angiogenesis.…”

Effects of steroidal and non‐steroidal antiandrogens on wild‐type and mutant androgen receptors

“…There have been reports supporting the use of nilutamide in bicalutamide-refractory cases. Prolonged response to nilutamide was observed in a patient after failure of bicalutamide therapy and its subsequent withdrawal [15]. There was a high response rate to nilutamide in hormone-resistant prostate cancer that had been exposed to prior antiandrogen therapy including bicalutamide [16].…”