title: Casodex (bicalutamide) 150-mg monotherapy compared with castration in patients with previously untreated nonmetastatic prostate cancer: results from two multicenter randomized trials at a median follow-up of 4 years.
abstract: OBJECTIVE
  To compare the efficacy, tolerability, and quality of life benefits of bicalutamide (Casodex) 150-mg/day monotherapy and castration in previously untreated nonmetastatic (M0) advanced prostate cancer.
  
  
  METHODS
  A total of 480 patients with Stage T3/T4 nonmetastatic disease randomly received oral bicalutamide 150 mg/day or castration (either bilateral orchiectomy or goserelin acetate [Zoladex] 3.6 mg every 28 days) in a 2:1 ratio in two open multicenter studies (studies 306 and 307). The design of these studies was similar to allow a pooled analysis.
  
  
  RESULTS
  In the combined survival analysis, at median follow-up of 202 and 205 weeks in studies 306 and 307, respectively, with 31% of the cases resulting in death, bicalutamide 150-mg monotherapy was statistically equivalent to castration; the risk of death from any cause was 7% less with bicalutamide than with castration (hazard ratio [HR] = 0.93). Data on time to treatment failure and objective progression could not be pooled, as results for these end points differed between the trials. In study 306, bicalutamide 150-mg monotherapy increased time to objective progression (HR = 0.58; P = 0.033) and treatment failure (HR = 0.66; P = 0.074), whereas in study 307, time to progression (HR = 1.35; P = 0.0471) and treatment failure (HR = 1.24; P = 0.097) favored castration. Bicalutamide therapy showed significant advantages over castration for both sexual interest (P = 0.029) and physical capacity (P = 0.046). Bicalutamide 150-mg monotherapy was well tolerated.
  
  
  CONCLUSIONS
  Bicalutamide 150-mg monotherapy provides a similar survival outcome to castration in previously untreated patients with nonmetastatic advanced prostate cancer and confers statistically significant benefits over castration with respect to sexual interest and physical capacity.
authors.affiliation: University of Copenhagen, Denmark.
authors.forename: P
authors.initials: P
authors.lastname: Iversen
authors.forename: C J
authors.initials: CJ
authors.lastname: Tyrrell
authors.forename: A V
authors.initials: AV
authors.lastname: Kaisary
authors.forename: J B
authors.initials: JB
authors.lastname: Anderson
authors.forename: L
authors.initials: L
authors.lastname: Baert
authors.forename: T
authors.initials: T
authors.lastname: Tammela
authors.forename: M
authors.initials: M
authors.lastname: Chamberlain
authors.forename: K
authors.initials: K
authors.lastname: Carroll
authors.forename: K
authors.initials: K
authors.lastname: Gotting-Smith
authors.forename: G R
authors.initials: GR
authors.lastname: Blackledge
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000726:Androgen Antagonists / Q000008:administration & dosage*; D000813:Anilides / Q000008:administration & dosage*; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D002369:Castration; D018450:Disease Progression; D004311:Double-Blind Method; D005500:Follow-Up Studies; D017273:Goserelin / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009570:Nitriles; D011471:Prostatic Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D011788:Quality of Life; D015996:Survival Rate; D013997:Time Factors; D014105:Tosyl Compounds
chemical_list: D000726:Androgen Antagonists; D000813:Anilides; D018931:Antineoplastic Agents, Hormonal; D009570:Nitriles; D014105:Tosyl Compounds; D017273:Goserelin; C053541:bicalutamide