Bicalutamide 150 mg as First-Line Monotherapy of Patients with Low and Intermediate Risk Prostatic Cancer

Wilmosh Mermershtain, Lazarev Irina, Goldinger Gil, Shani-Shrem Noa and Rouvinov Keren

Department of Oncology, Soroka University Medical Center, Israel

^*Correspondance to: Wilmosh Mermershtain 

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Abstract:

Introduction: Bicalutamide (Casodex) is a competitive androgen receptor antagonist that inactivates androgen-regulated prostate cell growth and function, leading to cell apoptosis and inhibition of prostate cancer growth. In several countries, Bicalutamide 150 mg/day is approved in men with locally advanced non-metastatic prostate cancer as immediate therapy either in adjuvant setting, or as an alternative to surgical or medical castration.Many patients with prostate cancer for whom hormonal therapy is indicated are physically and sexually active. Quality of life is therefore a critical issue when considering treatment options.Material and
Methods: Seventy-six patients received bicalutamide, 150 mg once daily, as a first-line therapy for low or intermediate risk prostate cancer. The median age of the patients in the study was 73.9 years (range 65-83). 49 pts were low risk (Gleason score 4-9 pts, 5-3 pts, and 6-37 pts.), 26 pts - intermediate risk (Gleason score 7) and 1 patient had metastatic disease.The average PSA levels at diagnosis was 13.5 ng/ml (range 5.65-45). The average PSA levels at the beginning of the treatment was 11.6 ng/ml (range 0.26-45). The median follow-up was 3.7 years (range 1-5). All pts received prophylactic breast irradiation before the start of treatment.Results: 90% of patients demonstrated PSA declines of greater than 50%. The average PSA level at end of treatment was 1.02 ng/ml (range 0.01-7.86). The average nadir was 0.9 ng/ml (range 0.01- 7.86). The most frequent side effect was mild gynecomastia in 15 (20%) of the pts.Conclusion: Antiandrogen monotherapy is effective and well tolerated and resulting in significantly lesser loss in sexual interest and a better physical capacity.

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Cite the Article:

Mermershtain W, Irina L, Gil G, Noa S-S, Keren R. Bicalutamide 150 mg as First-Line Monotherapy of Patients with Low and Intermediate Risk Prostatic Cancer. Clin Oncol. 2019; 4: 1612.