title: Combination therapy with flutamide and castration (orchiectomy or LHRH agonist): the minimal endocrine therapy in both untreated and previously treated patients.
abstract: Patients (154) with clinical stage D2 prostate cancer with no previous endocrine therapy or chemotherapy received the combination therapy with the pure antiandrogen Flutamide and the LHRH agonist [D-Trp6]LHRH ethylamide for an average of 22 months (3-49 months). The objective response to the treatment was assessed according to the criteria of the US NPCP. There was a 6.3-fold increase (29.2 vs 4.6%) in the percentage of patients who achieved a complete response as compared to the results achieved in five recent studies limited to removal (orchiectomy) or blockade (DES or Leuprolide) of testicular androgens. Only 4.5% of patients did not respond to the combination therapy as compared to an average of 18% by standard therapy. The duration of response is also significantly increased in the patients who received the combination therapy. The death rate was decreased by approximately 2-fold between 2 and 3 yr of treatment. The marked (6.3-fold) improvement in the rate of complete objective responses coupled with the 4-fold decrease in the number of non-responders, the increased duration of the positive responses and the 2-fold decrease in the death rate at 2-3 yr of treatment are obtained with the combination therapy using Flutamide and castration with no or minimal secondary effects.
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D000728:Androgens; D000813:Anilides / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D005069:Evaluation Studies as Topic; D005485:Flutamide / Q000494:pharmacology / Q000627:therapeutic use*; D007987:Gonadotropin-Releasing Hormone / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D009376:Neoplasms, Hormone-Dependent / Q000188:drug therapy / Q000601:surgery / Q000628:therapy; D009919:Orchiectomy; D011471:Prostatic Neoplasms / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D011944:Receptors, Androgen / Q000187:drug effects; D017329:Triptorelin Pamoate
chemical_list: D000728:Androgens; D000813:Anilides; D011944:Receptors, Androgen; D017329:Triptorelin Pamoate; D007987:Gonadotropin-Releasing Hormone; D005485:Flutamide