Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Nonsteroidal antiandrogens are generally used in conjunction with castration as combined androgen blockade. However, the changing profile of patients with prostate cancer has made monotherapy with a nonsteroidal antiandrogen an attractive alternative therapeutic approach, offering potential quality-of-life benefits over conventional treatment modalities. Of available antiandrogens, monotherapy with bicalutamide has been most extensively evaluated. Combined data from 2 studies at a median follow-up time of 6.3 years revealed no statistically significant difference in overall survival between bicalutamide 150-mg monotherapy and castration in patients with nonmetastatic locally advanced disease. In patients with metastatic disease, there was a statistically significant difference (6 weeks) in overall survival in favor of castration. Bicalutamide monotherapy is associated with significant quality-of-life benefits (sexual interest and physical capacity), with preliminary data suggesting that the risk of osteoporosis may also be reduced by bicalutamide 150-mg monotherapy compared with castration. In general, bicalutamide is well tolerated, with a predictable adverse-effect profile. Breast pain (40%) and gynecomastia (49%) are the most common adverse events seen during monotherapy with this drug. In summary, the availability of bicalutamide 150-mg monotherapy broadens treatment options for men with locally advanced prostate cancer, offering a viable and attractive alternative to castration in this patient population. Ongoing studies will determine the role of bicalutamide in the treatment of localized disease.
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PMID:Antiandrogen monotherapy: a new form of treatment for patients with prostate cancer. 1150 39

Bicalutamide is an effective, non-steroidal antiandrogen, suitable for oral, once daily administration. Bicalutamide 50 mg plus LHRHa is at least as effective as flutamide plus LHRHa in terms of survival and time to progression. Monotherapy with bicalutamide 150 mg once daily has similar survival rates compared with castration in advanced non-metastatic disease. Current clinical trials are evaluating the efficacy of bicalutamide as monotherapy in the setting of adjuvant therapy in early stage disease. Sexual interest appears to be better preserved with bicalutamide than with castration. Breast pain and gynecomastia are the most common side effects. Bicalutamide is not associated with interstitial pneumonitis and difficulty with light/dark adaptation seen with nilutamide, and in 50 mg/day dosage causes a lower incidence of diarrhea than flutamide 750 mg/day. Changes in hepatic function are usually transient and resolve or improve during therapy or after bicalutamide treatment is withdrawn.
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PMID:[The role of bicalutamide in the treatment of prostate cancer]. 1201 96