High dose bicalutamide for androgen independent prostate cancer: Effect of prior hormonal therapy
High dose bicalutamide for androgen independent prostate cancer: Effect of prior hormonal therapy
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DOI：
10.1016/s0022-5347(01)64039-4
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发表时间：
1998-01-01
影响因子：
6.6
通讯作者：
Bubley, GJ
中科院分区：
文献类型：
--
作者：
Joyce, R;Fenton, MA;Bubley, GJ
目的：进行了抗雄激素比卡鲁胺150毫克/天治疗雄激素非依赖性前列腺癌的初步研究。这项研究是基于雄激素独立病例可能对其他激素药物有反应的可能性。材料和方法：研究纳入31例不依赖雄激素的前列腺特异性抗原（PSA）升高和疾病进展的病例。PSA测量被用作评估疗效的主要方法。然而，PSA下降也与临床状态相关。结果：7例患者PSA下降超过50%，持续2个月或更长时间，总有效率为22.5%。与不使用氟他胺进行雄激素剥夺治疗的患者（6%的应答率）相比，几乎只在长期使用氟他胺作为完全雄激素阻断方案一部分的患者中观察到应答（43%的应答率）。在7例PSA应答患者中，比卡鲁胺显著改善了患者的行为状态，4例患者镇痛需求减少，3例患者无症状。每天150毫克的比卡鲁胺耐受性良好，最常见的副作用是轻微加剧潮热。结论：该剂量的比卡鲁胺对一些非雄激素依赖型前列腺癌患者有一定的疗效，特别是对那些以前长期使用氟他胺治疗的患者。该研究表明，以前的抗雄激素治疗改变了对随后激素药物的反应。
Purpose: A pilot study of the antiandrogen bicalutamide at 150 mg. a day for androgen independent prostate cancer was performed. This study was based on the possibility that androgen independent cases might display responses to additional hormonal agents.Materials and Methods: The study included 31 androgen independent cases with an increasing prostate specific antigen (PSA) and progressive disease. PSA measurements were used as the primary method of assessing response. However, PSA decline was also correlated with clinical status.Results: Seven patients demonstrated PSA declines of greater than 50% for 2 months or more, for an overall response rate of 22.5%. Responses were observed almost exclusively in patients treated with long-term flutamide as part of a complete androgen blockade regimen (43% response rate) in contrast to patients treated with androgen deprivation without flutamide (6% response rate). Of the 7 PSA responding patients bicalutamide resulted in a significant improvement in performance status and a decrease in analgesic requirement in 4 and 3 remained asymptomatic. Bicalutamide at 150 mg. a day was well tolerated, with the most frequent side effect being mild exacerbation of hot flashes.Conclusions: Bicalutamide at this dose is modestly effective for some patients with androgen independent prostate cancer, particularly for those previously treated with long-term flutamide, This study indicates that previous antiandrogen therapy alters the response to subsequent hormonal agents.