Long-term side-effects of intermittent androgen suppression therapy in prostate cancer: results of a phase II study.
OBJECTIVE
To assess the feasibility and tolerability of intermittent androgen suppression therapy (IAS) in prostate cancer.


METHODS
Patients with recurrent or metastic prostate cancer received cyclical periods of treatment with leuprolide acetate and nilutamide for 8 months, and rest periods. Cycles were repeated at progression until the treatment failed to achieve normal prostate-specific antigen (PSA) levels. Patients were followed with PSA level, testosterone level, haemoglobin level, weight and bone mineral density evaluations. The median time to treatment failure, recovery from anaemia, or normalization of testosterone level was estimated by the Kaplan-Meier method.


RESULTS
In all, 95 patients received 245 cycles; the median duration of rest periods was 8 months and median time to treatment failure 47 months. Testosterone recovery during rest periods was documented in 117 (61%) of cycles. Anaemia was mild and reported in 33%, 44% and 67% of cycles 1, 2 and 3, respectively. Sexual function recovered during the rest periods in 47% of cycles. There was no significant overall change in body mass index at the end of the treatment period. Osteoporosis was documented in at least one site evaluated in 41 patients (37%).


CONCLUSIONS
IAS has the potential to reduce side-effects, including recovery of haemoglobin level, return of sexual function and absence of weight gain at the end of the study period.
Malone
Shawn
S
Department of Radiation and Medical Oncology, Ottawa Hospital Regional Cancer Centre, Ottawa, Ontario, Canada. smalone@ottawahospital.on.ca
Perry
Gad
G
Segal
Roanne
R
Dahrouge
Simone
S
Crook
Juanita
J
D000368:Aged; D000369:Aged, 80 and over; D000726:Androgen Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D006801:Humans; D048289:Imidazolidines / Q000009:adverse effects / Q000627:therapeutic use*; D016729:Leuprolide / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy*; D010024:Osteoporosis / Q000139:chemically induced; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000532:radiotherapy; D013739:Testosterone / Q000097:blood; D016896:Treatment Outcome
D000726:Androgen Antagonists; D000970:Antineoplastic Agents; D048289:Imidazolidines; D013739:Testosterone; C021277:nilutamide; D017430:Prostate-Specific Antigen; D016729:Leuprolide