title: Alternative antiandrogen therapy in patients with castration-resistant prostate cancer: a single-center experience.
abstract: Outcomes of alternative (second-line) antiandrogen therapy in 112 patients with relapsing prostate cancer after first-line hormonal therapy were analyzed. A good response (prostate-specific antigen [PSA] decrease 50%) and a partial response (PSA decrease of 0–50%) by switching from bicalutamide (BCL) to flutamide (FLT) and from FLT to BCL were achieved in 35.4% (28/79) and 30.4% (24/79), and in 45.0% (9/20) and 20.0% (4/20) of cases, respectively. A good response and a partial response with the change from chlormadinone acetate (CMA) to a non-steroidal antiandrogen (FLT or BCL)and from a non-steroidal antiandrogen to CMA were obtained in 25.0% (2/8) and 37.5% (3/8), and in 20.0% (1/5) and 0% (0/5)of cases, respectively. In multivariate analyses, a second-line good response was significantly predictive of cause-specific survival from first therapy relapse to cancer death in all patients. Patients (52/112, 46.4%) with 30% decrease in PSA levels were associated with significantly better cause-specific survival as measured from the start of first-line treatment and first-line relapse.
authors.affiliation: Department of Urology, The University of Kyorin, Mitaka, Tokyo, Japan. toke@ks.kyorin-u.ac.jp
authors.forename: Takatsugu
authors.initials: T
authors.lastname: Okegawa
authors.forename: Kikuo
authors.initials: K
authors.lastname: Nutahara
authors.forename: Eiji
authors.initials: E
authors.lastname: Higashihara
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000726:Androgen Antagonists / Q000627:therapeutic use*; D000813:Anilides / Q000627:therapeutic use; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D002715:Chlormadinone Acetate / Q000627:therapeutic use; D015331:Cohort Studies; D018572:Disease-Free Survival; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D019008:Drug Resistance, Neoplasm; D004359:Drug Therapy, Combination; D005485:Flutamide / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D009367:Neoplasm Staging; D009570:Nitriles / Q000627:therapeutic use; D009919:Orchiectomy; D017430:Prostate-Specific Antigen / Q000097:blood* / Q000187:drug effects; D011471:Prostatic Neoplasms / Q000097:blood* / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D014105:Tosyl Compounds / Q000627:therapeutic use; D017211:Treatment Failure
chemical_list: D000726:Androgen Antagonists; D000813:Anilides; D018931:Antineoplastic Agents, Hormonal; D009570:Nitriles; D014105:Tosyl Compounds; D002715:Chlormadinone Acetate; D005485:Flutamide; C053541:bicalutamide; D017430:Prostate-Specific Antigen