Clinical outcomes of anti-androgen withdrawal and subsequent alternative anti-androgen therapy for advanced prostate cancer following failure of initial maximum androgen blockade

  • Authors:
    • Hiroyuki Momozono
    • Hideaki Miyake
    • Hiromoto Tei
    • Ken‑Ichi Harada
    • Masato Fujisawa
  • View Affiliations

  • Published online on: March 10, 2016     https://doi.org/10.3892/mco.2016.817
  • Pages: 839-844
Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )
Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )


Abstract

The present study aimed to investigate the significance of anti-androgen withdrawal and/or subsequent alternative anti-androgen therapy in patients with advanced prostate cancer (PC) who relapsed after initial maximum androgen blockade (MAB). The present study evaluated the clinical outcomes of 272 consecutive advanced PC patients undergoing anti-androgen withdrawal and/or subsequent alternative anti‑androgen therapy with flutamide following the failure of initial MAB using bicalutamide. With the exception of 41 patients (15.1%) who did not undergo anti‑androgen withdrawal due to the characteristics of PC suggesting aggressive diseases, prostate‑specific antigen (PSA) declined from the baseline value in 83 patients (35.9%), including 18 (7.8%) with PSA decline >50%, but not in the remaining 148 (64.1%). No significant difference in the overall survival (OS) or cancer‑specific survival (CSS) among the three groups was observed based on the response to anti‑androgen withdrawal. Following the introduction of alternative anti‑androgen therapy with flutamide, PSA decline was observed in 185 patients (68.0%), including 103 (37.9%) who achieved a PSA reduction of >50%; however, the PSA level continued to elevate in the remaining 87 (32.0%). Furthermore, of the numerous factors examined, only the duration of the initial MAB therapy was shown to be significantly correlated with the PSA decline following alternative anti‑androgen therapy. Multivariate analysis of several factors identified revealed that only PSA decline following alternative anti‑androgen therapy was an independent predictor of CSS and OS. If initial MAB is effective, the introduction of alternative anti‑androgen therapy may be considered; however, anti‑androgen withdrawal should be omitted, irrespective of the characteristics of advanced PC.
View Figures
View References

Related Articles

Journal Cover

May 2016
Volume 4 Issue 5

Print ISSN: 2049-9450
Online ISSN:2049-9469

Sign up for eToc alerts

Recommend to Library

Copy and paste a formatted citation
APA
Momozono, H., Miyake, H., Tei, H., Harada, K., & Fujisawa, M. (2016). Clinical outcomes of anti-androgen withdrawal and subsequent alternative anti-androgen therapy for advanced prostate cancer following failure of initial maximum androgen blockade. Molecular and Clinical Oncology, 4, 839-844. https://doi.org/10.3892/mco.2016.817
MLA
Momozono, H., Miyake, H., Tei, H., Harada, K., Fujisawa, M."Clinical outcomes of anti-androgen withdrawal and subsequent alternative anti-androgen therapy for advanced prostate cancer following failure of initial maximum androgen blockade". Molecular and Clinical Oncology 4.5 (2016): 839-844.
Chicago
Momozono, H., Miyake, H., Tei, H., Harada, K., Fujisawa, M."Clinical outcomes of anti-androgen withdrawal and subsequent alternative anti-androgen therapy for advanced prostate cancer following failure of initial maximum androgen blockade". Molecular and Clinical Oncology 4, no. 5 (2016): 839-844. https://doi.org/10.3892/mco.2016.817