Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Paper
  • Published:

Bicalutamide vs cyproterone acetate in preventing flare with LHRH analogue therapy for prostate cancer—a pilot study

Prostate Cancer and Prostatic Diseases volume 8, pages 91–94 (2005)Cite this article

Abstract

Objective: To evaluate the efficacy of bicalutamide vs cyproterone acetate in preventing PSA flare (as a surrogate for tumour flare) for patients requiring luteinizing hormone-releasing hormone (LHRH) analogue therapy for prostate cancer.

Patients and Methods: In this pilot study, 40 men were randomized 1 : 1 to bicalutamide 50 mg o.d. or cyproterone acetate 100 mg t.i.d. 5 days prior to goserelin acetate and continued for 21 days thereafter. PSA, luteinizing hormone (LH), follicle-stimulating hormone (FSH) and testosterone were obtained before treatment and on days 6, 8, 10, 16, 21 and 28. Primary end point was PSA. Hormone profile and clinical features including urinary symptoms and bone pain were secondary end points.

Results: Both groups were equally matched apart from serum creatinine and ALP. The speed and magnitude of the percentage change in median PSA from baseline was increased for the CPA group but there was no statistically significant difference in the two groups. Although those receiving bicalutamide all showed a testosterone peak, this remained within the normal range. No difference in the frequency of drug-specific adverse events was found. None of the patients died or developed cord compression during the study period.

Conclusion: Bicalutamide is able to suppress the initial PSA surge as effectively as cyproterone acetate albeit slightly delayed. A statement whether bicalutamide is equally good at preventing clinical flare cannot be made and should be assessed in an appropriately powered study.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2

Similar content being viewed by others

References

  1. Miller DC et al. Prostate carcinoma presentation, diagnosis and staging: an update from the National Cancer Database. Cancer 2003; 98: 1169–1178.

    Article  Google Scholar 

  2. Mahler C . Is disease flare a problem? Cancer 1993; 72: 3799–3802.

    Article  CAS  Google Scholar 

  3. Schellhammer PF et al. Clinical benefits of bicalutamide compared with flutamide in combined androgen blockade for patients with advanced prostatic carcinoma: final report of a double-blind, randomized, multicenter trial. Urology 1997; 50: 330–336.

    Article  CAS  Google Scholar 

  4. Schellhammer PF et al. A controlled trial of bicalutamide versus flutamide, each in combination with luteinizing hormone-releasing hormone analogue therapy in patients with advanced prostate cancer. Urology 1995; 45: 745–752.

    Article  CAS  Google Scholar 

  5. Blackledge G . Casodex—mechanisms of action and opportunities for usage. Cancer 1993; 72: 3830–3833.

    Article  CAS  Google Scholar 

  6. Crawford ED et al. A controlled trial of leuprolide with and without flutamide in prostatic carcinoma. N Eng J Med 1989; 321: 419–424.

    Article  CAS  Google Scholar 

  7. Keuppens F et al. Zoladex and flutamide versus bilateral orchiectomy. A randomized phase III EORTC 30853 study. Cancer 1990; 66: 1045–1057.

    Article  CAS  Google Scholar 

  8. Labrie F, Dupont A, Belanger A, Lachance R . Flutamide eliminates the risk of disease flare in prostatic cancer patients treated with a luteinizing hormone-releasing hormone agonist. J Urol 1987; 138: 804–806.

    Article  CAS  Google Scholar 

  9. Schroder FH . Cyproterone acetate—mechanism of action and clinical effectiveness in prostate cancer treatment. Cancer 1993; 72: 3810–3815.

    Article  CAS  Google Scholar 

  10. Schellhammer PF . An evaluation of bicalutamide in the treatment of prostate cancer. Expert Opin Pharmacol 2002; 3: 1313–1328.

    Article  CAS  Google Scholar 

  11. Verhelst J et al. Endocrine profiles during administration of the new non-steroidal anti-androgen Casodex in prostate cancer. Clin Endocrinol 1994; 41: 525–530.

    Article  CAS  Google Scholar 

  12. Tomera K et al. The gonadotropin-releasing hormone antagonist abarelix depot versus luteinizing hormone releasing hormone agonists leuprolide or goserelin: initial results of endocrinological and biochemical efficacies in patients with prostate cancer. J Urol 2001; 165: 1585–1589.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

This study was supported by an educational grant from Astra Zeneca. We thank the urology outpatients staff of Southmead Hospital, Bristol, UK for their contribution in organizing the additional clinics.

Author information

Authors and Affiliations

  1. Bristol Urological Institute, Southmead Hospital, UK

    M Sugiono, M H Winkler, A A Okeke, M Benney & D A Gillatt

Authors
  1. M Sugiono
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M H Winkler
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. A A Okeke
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M Benney
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. D A Gillatt
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to M H Winkler.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sugiono, M., Winkler, M., Okeke, A. et al. Bicalutamide vs cyproterone acetate in preventing flare with LHRH analogue therapy for prostate cancer—a pilot study. Prostate Cancer Prostatic Dis 8, 91–94 (2005). https://doi.org/10.1038/sj.pcan.4500784

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.pcan.4500784

Keywords

This article is cited by

Search

Advanced search

Quick links