Bicalutamide monotherapy versus flutamide plus goserelin in prostate cancer: updated results of a multicentric trial |
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Authors: | Boccardo Francesco,Barichello Mario,Battaglia Michele,Carmignani Giorgio,Comeri Giancarlo,Ferraris Valentino,Lilliu Sergio,Montefiore Franco,Portoghese Filippo,Cortellini Pietro,Rigatti Patrizio,Usai Enzo,Rubagotti Alessandra Italian Prostate Cancer Group |
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Affiliation: | Department of Medical Oncology, University and National Cancer Research Institute of Genoa, Largo R. Benzi 10, 16132 Genoa, Italy. francesco.boccardo@istge.it |
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Abstract: | OBJECTIVES: To compare the efficacy of bicalutamide monotherapy to maximal androgen blockade in advanced prostatic cancer. PATIENTS AND METHODS: Previously untreated patients with histologically proven stage C or D (American Urological Association Staging System) disease were randomly allocated to either bicalutamide (B) or goserelin plus flutamide (G+F). After disease progression, patients treated with B were assigned to castration. The primary endpoint for this trial was overall survival. Prostate cancer-specific survival and progression were included among secondary endpoints. RESULTS: In total 108 patients received B and 112 received G+F. At a median follow-up time of 54 months (range 1-89), 151 patients progressed and 113 died. There was no significant difference in the duration of either progression-free or overall survival. Hazards of progression, death and cancer-specific death, corrected by disease stage, tumor grade and baseline PSA level, showed that patients initially assigned to B had a higher risk of progression but a comparable risk of death and cancer-specific death with the exception of patients with G3 tumors who had an increased risk of death). CONCLUSIONS: In patients with well or moderately well differentiated tumors, B monotherapy followed by castration may offer the same survival chance as maximal androgen deprivation. In those patients it thus represents a reasonable choice that can avoid the side effects of androgen deprivation for considerable periods of time. |
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