| Adding bicalutamide 150 mg to radiotherapy significantly extends survival in men with locally advanced prostate cancer
The bicalutamide (CASODEXTM) Early Prostate Cancer (EPC) program includes three randomized, double-blind, placebo-controlled trials involving over 8000 men with early non-metastatic prostate cancer, making it the world’s largest prostate cancer treatment study. Our paper reports the effects of treatment with bicalutamide 150 mg in the subset of patients who received radiotherapy as their standard care at 7.2 years’ median follow-up.1 Although adding bicalutamide 150 mg to standard care did not result in significant additional benefit in patients with localized disease, in patients with locally advanced disease, bicalutamide 150 mg adjuvant to radiotherapy confers significant clinical benefits, including a significant 35% reduction in the risk of death compared with radiotherapy alone. The overall survival benefit observed with adjuvant bicalutamide 150 mg compares favorably to that of adjuvant goserelin (ZOLADEXTM) in the RTOG 85-31 study, which has a similar patient population and median follow-up time (7.6 years).2 This is of particular importance as goserelin is the only other hormonal therapy with a demonstrated overall survival benefit in this setting. Patients and physicians may wish to consider bicalutamide 150 mg as an alternative to castration-based therapy in the setting of locally advanced disease being treated by radiotherapy.
Bibliographical
references: 2Pilepich MV et al: “Androgen suppression adjuvant to definitive radiotherapy in prostate carcinoma – long-term results of phase III RTOG 85-31”, Int J Radiat Oncol Biol Phys. 2005; 61: 1285-90
William A. See Department of Urology, Medical College of Wisconsin, Milwaukee, WI, US
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