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Bicalutamide added to radiotherapy improves prostate cancer survival
Last Updated: 2006-09-11 14:11:18 -0400 (Reuters Health)
NEW YORK (Reuters Health) - Daily treatment with bicalutamide (Casodex) following radiotherapy appears to improve the survival of men with locally advanced prostate cancer, new research suggests. Moreover, the survival benefit seems to be on par with what is seen when a medical castration-based therapy is added to radiotherapy.
Given these findings, the authors believe that bicalutamide, an antiandrogen, may be a suitable, better-tolerated alternative to castration therapies, which can adversely affect quality of life.
As reported in the August issue of the Journal of Cancer Research and Clinical Oncology, Dr. William A. See, from the Medical College of Milwaukee, and colleagues assessed the survival outcomes of 1370 patients with early prostate cancer (T1-4, N any, M0) who were randomized to receive bicalutamide (150 mg) or placebo once daily following radiotherapy. The median follow-up period was 7.2 years.
Treatment with bicalutamide was associated with significant improvements in progression-free and overall survival, the report indicates.
Compared with radiotherapy alone, the addition of bicalutamide cut the risk of objective progression by 44%. Likewise, treatment with this agent reduced the overall risk of death by 35%.
Further analysis showed that the improvement in overall survival with bicalutamide was largely driven by its ability to cut prostate cancer-related deaths.
Unlike their peers with locally advanced disease, those with localized disease gleaned no benefit from adding bicalutamide to radiotherapy, the report indicates.
"This is the first evidence of an overall survival benefit for any non-castration-based therapy in this setting," the authors point out. Bicalutamide, they say, "has additional quality of life benefits relative to castration in terms of maintaining sexual interest, physical ability, and bone mineral density."
J Cancer Res Clin Oncol 2006;132:S7-S16.
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