Antiandrogenic substances in the management of prostatic cancer.
Endocrine-active and pure antiandrogens have different mechanisms of action and different endocrinological effects in the intact male. With pure antiandrogens as a monotherapy an elevation of plasma testosterone occurs which probably leads to the preservation of potency, the clinical significance of which in the management of prostatic carcinoma is not known. Plasma testosterone is reduced to pretreatment levels after 12 months. Longer observations are not available. In total androgen suppression regimens both types of antiandrogens have been shown in prospective trials to be at least equally effective as standard treatment. The clinical effectiveness of CPA alone in prostatic cancer has been shown to be equal to that of DES 1 mg tid. Sufficiently large prospective studies on flutamide alone in comparison to standard treatment have not been carried out. The use of antiandrogens is recommended during the initial 4 weeks of management of prostatic carcinoma patients with LH-RH agonists to prevent disease flare-up and to achieve higher early response rates in selective patients.
Schröder
F H
FH
Department of Urology, Erasmus University, Rotterdam, The Netherlands.
D000726:Androgen Antagonists / Q000494:pharmacology / Q000627:therapeutic use*; D003534:Cyproterone / Q000031:analogs & derivatives / Q000494:pharmacology; D017373:Cyproterone Acetate; D005485:Flutamide / Q000494:pharmacology; D006801:Humans; D008297:Male; D011471:Prostatic Neoplasms / Q000188:drug therapy*
D000726:Androgen Antagonists; D017373:Cyproterone Acetate; D005485:Flutamide; D003534:Cyproterone