title: The non-steroidal antiandrogen, bicalutamide ('Casodex'), may preserve bone mineral density as compared with castration: results of a preliminary study.
abstract: The impact of bicalutamide (Casodex) monotherapy on bone mineral density (BMD) was investigated in patients with locally advanced prostate cancer. BMD was assessed after treatment with bicalutamide 150 mg daily ( n=21) or by medical castration (goserelin acetate 3.6 mg every 28 days) ( n=8) for a median of 287 weeks. In 38% of castration compared with 17% of bicalutamide patients, femoral neck Z-scores were < or =-1 SD of the reference value (accepted as a two to three times increased risk of fracture) and T-scores were < or =-2.5 SD (World Health Organization definition of osteoporosis in white females). Total hip Z-scores were < or =-1 in 43% of castration patients and 13% of bicalutamide patients. In 38% of patients, lumbar spine BMD was affected by degenerative disease. These preliminary data suggest that there may be an advantage in terms of BMD in using bicalutamide monotherapy compared with castration; a benefit confirmed in a recent prospective randomised study.
authors.affiliation: Clinical Trials Unit, Plymouth Oncology Centre, Plymouth, PL6 8DH, UK. chris.tyrrell@phnt.swest.nhs.uk
authors.forename: C J
authors.initials: CJ
authors.lastname: Tyrrell
authors.forename: G M
authors.initials: GM
authors.lastname: Blake
authors.forename: P
authors.initials: P
authors.lastname: Iversen
authors.forename: A V
authors.initials: AV
authors.lastname: Kaisary
authors.forename: I
authors.initials: I
authors.lastname: Melezinek
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000813:Anilides / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D015519:Bone Density / Q000187:drug effects*; D006801:Humans; D008297:Male; D009570:Nitriles; D009919:Orchiectomy; D011471:Prostatic Neoplasms / Q000188:drug therapy*; D011944:Receptors, Androgen / Q000627:therapeutic use*; D014105:Tosyl Compounds
chemical_list: D000813:Anilides; D000970:Antineoplastic Agents; D009570:Nitriles; D011944:Receptors, Androgen; D014105:Tosyl Compounds; C053541:bicalutamide