Use of the nonsteroidal anti-androgen Casodex in advanced prostatic carcinoma.
Pure anti-androgens have advantages over steroidal anti-androgens of the cyproterone acetate type in the treatment of patients with advanced prostate cancer because they do not have steroidal side effects or such a marked inhibitory effect on libido. In addition, the long half-life of a pure anti-androgen such as Casodex results in maintenance of high serum anti-androgen concentrations, which allays concern over the clinical significance of any small rise in serum testosterone concentrations. The anti-androgen of choice for the treatment of androgen-responsive diseases has yet to be defined. However, this choice should be based on extensive clinical evaluations of a drug as monotherapy. As always, the clinical efficacy and tolerability of the drug will be important factors in determining the anti-androgen of choice; however, favorable pharmacokinetics should be emphasized in the treatment of a disease in which high and sustained concentrations of antagonist must be present to prevent androgenic stimulation. Casodex, a pure anti-androgen with a relatively long half-life, produces objective and subjective responses similar to those of surgical or pharmacologic castration and is well tolerated. Its profile makes it a strong candidate for consideration as the future anti-androgen of choice in the treatment of advanced prostate cancer.
Kennealey
G T
GT
ICI Pharmaceuticals Group, ICI Americas Inc., Wilmington, Delaware.
Furr
B J
BJ
D000726:Androgen Antagonists / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D000813:Anilides / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D000818:Animals; D006801:Humans; D008297:Male; D009570:Nitriles; D011471:Prostatic Neoplasms / Q000188:drug therapy*; D014105:Tosyl Compounds
D000726:Androgen Antagonists; D000813:Anilides; D009570:Nitriles; D014105:Tosyl Compounds; C053541:bicalutamide