Comparison of maximal and more maximal intermittent androgen blockade during 5-year treatment of advanced prostate cancer T3NxMx-1.

Abstract

PURPOSE:

Patients with advanced prostate cancer (PCa) benefit from intermittent maximal androgen blockade (IMAB) therapy when time-off period (TOP) is extended. A comparative study included patients who received uninterrupted finasteride (mMAB) treatment and those who did not MAB.

METHODS:

A randomized group of 63 patients with PCa (T3NxM1; Gl. 6-7) was prospectively examined for 5 years: group A (GrA)-31 patients receiving MAB and group B (GrB)-32-mMAB. Testosterone inactivating pharmaceuticals period (TIP) lasted until PSA was 0.2 ng/ml (group A) and 0.1 ng/ml (group B), followed by MAB (TOP) discontinuation. CR, PR, BP, and TP evaluation criteria were adopted. Tests were carried out every 3 months.

RESULTS:

After 5 years, five patients in GrA did not reach PSA concentration nadir value and were eliminated from final evaluation. TIP1 for both groups was comparable; TIP2-4 were shorter in GrB. TOP1-3 for GrB were longer than in GrA, and TOP4 was comparable in both groups. Treatment effects were, respectively, CR, 1(3.2%) and 17(53%); PR, 9(29%) and 3(9%); BP 11(35.5%) and 5(15.6%); TP, 10(32.2%) and 7(22%). Before the therapy, QoL of 63 patients was between 4 and 5 points; after 5 years for patients with CR and PR, between 1 and 2 points, but for BP, between 3 and 4 points.

CONCLUSIONS:

Better therapy effects were observed in patients treated with mMAB, receiving additional finasteride. Response to the treatment improved by nearly double, and progression was two times lower. TOP after TIP was extending in time.

• Authors: Slawomir A Dutkiewicz
• Journal: International urology and nephrology (Int Urol Nephrol) Vol. 44 Issue 2 Pg. 487-92 (Apr 2012) ISSN: 1573-2584 [Electronic] Netherlands
• PMID: 21932036 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)

Chemical References

• Androgen Antagonists
• Prostate-Specific Antigen

Topics

• Aged
• Aged, 80 and over
• Androgen Antagonists (administration & dosage)
• Biopsy
• Disease Progression
• Dose-Response Relationship, Drug
• Drug Administration Schedule
• Endosonography
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Neoplasm Staging
• Prospective Studies
• Prostate-Specific Antigen (blood)
• Prostatic Neoplasms (blood, drug therapy, pathology)
• Time Factors
• Treatment Outcome