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Spotlight on Bicalutamide 150mg in the Treatment of Locally Advanced Prostate Cancer

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Abstract

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. It is administered orally as a once-daily dose. In the EU and a number of other countries, bicalutamide 150 mg/day is approved in men with locally advanced nonmetastatic prostate cancer as immediate therapy either as an adjuvant to active treatment or as monotherapy as an alternative to surgical or medical castration.

Combined analysis of the three trials that comprise the bicalutamide Early Prostate Cancer programme showed that bicalutamide administered in conjunction with standard care in men with locally advanced prostate cancer offers disease-free survival benefits over standard care alone and is generally well tolerated. Overall survival was improved to a greater extent in the subgroup of patients who received bicalutamide plus radiation therapy compared with radiation therapy alone. Men with localised prostate cancer do not benefit from the addition of bicalutamide to standard care. Combined analysis of two other studies in men with locally advanced prostate cancer show that bicalutamide monotherapy offers better tolerability and higher health-related quality-of-life scores for sexual interest and physical capacity compared with surgical or medical castration, while achieving disease-free and overall survival durations that were not significantly different. Thus, when treatment options are being evaluated, bicalutamide as adjuvant therapy or monotherapy should be considered as an alternative to other available hormonal therapies in men with locally advanced prostate cancer, especially in those who wish to maintain an active lifestyle.

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Notes

  1. The use of trade names is for product identification purposes only and does not imply endorsement.

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Acknowledgements

The full text article in Drugs 2006; 66 (6): 837–850 was reviewed by: P.-A. Abrahamsson, Department of Urology, Malmö University Hospital, Lund University, Malmö, Sweden; G. Di Lorenzo, Department of Endocrinology and Oncology and Medical Oncology-Prostate Cancer Center, University of Naples, Naples, Italy; A.V. Kaisary, Royal Free Hospital, London, UK; W. Oh, Lank Center for Genitourinary Oncology, Harvard Medical School, Dana-Farber Cancer Institute, Boston, Massachusetts, USA; P.F. Schellhammer, Department of Urology, East Virginia Medical School, Norfolk, Virginia, USA; P. Sieber, Urological Associates of Lancaster, Lancaster, Pennsylvania, USA.

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Authors and Affiliations

  1. Wolters Kluwer Health | Adis, 41 Centorian Drive, Private Bag 65901, Mairangi Bay, Auckland, 1311, New Zealand

    Keri Wellington & Susan J. Keam

  2. editorial office of Wolters Kluwer Health, Conshohocken, Pennsylvania, USA

    Keri Wellington & Susan J. Keam

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  1. Keri Wellington
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  2. Susan J. Keam
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Correspondence to Susan J. Keam.

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Derived from abstract and summary text of an Adis Drug Evaluation originally published in full in Drugs 2006; 66 (6): 837–850. The manufacturer of the agent under review was offered an opportunity to comment on the original article during the peer review process; changes based on any comments received were made on the basis of scientific and editorial merit.

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Wellington, K., Keam, S.J. Spotlight on Bicalutamide 150mg in the Treatment of Locally Advanced Prostate Cancer. Drugs Aging 24, 169–171 (2007). https://doi.org/10.2165/00002512-200724020-00008

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