Faculty Collaboration Database

Bicalutamide 150 mg in addition to standard care in patients with localized or locally advanced prostate cancer: results from the second analysis of the early prostate cancer program at median followup of 5.4 years. J Urol 2004 Nov;172(5 Pt 1):1865-70

Date

11/16/2004

Pubmed ID

15540740

DOI

10.1097/01.ju.0000140159.94703.80

Scopus ID

2-s2.0-5444248630 (requires institutional sign-in at Scopus site)   196 Citations

Abstract

PURPOSE: We evaluated the efficacy and tolerability of 150 mg bicalutamide daily given in addition to standard care, in patients with localized or locally advanced prostate cancer.

MATERIALS AND METHODS: The bicalutamide Early Prostate Cancer program consists of 3 randomized, double blind, placebo controlled trials prospectively designed for combined analysis. A total of 8,113 men with T1b-T4, M0, any N (N0 in 1 trial) prostate cancer were randomized to bicalutamide 150 mg/day (4,052) or placebo (4,061) in addition to standard care (radical prostatectomy, radiotherapy or watchful waiting). Primary end points were objective progression-free survival (PFS) and overall survival.

RESULTS: At median 5.4 years of followup (21.6% progression events) bicalutamide significantly improved PFS in the overall population. This result was driven by positive results in trials 24 and 25, with the North American trial (trial 23) showing no difference. Patients with locally advanced disease gained most benefit from bicalutamide in terms of PFS, irrespective of underlying therapy. Overall survival was similar in the bicalutamide and placebo groups, across the program and in each trial. Among watchful waiting patients survival appeared to be improved with bicalutamide in those with locally advanced disease, whereas survival appeared to be reduced with bicalutamide in those with localized disease. The most common adverse events with bicalutamide were gynecomastia and breast pain. Other adverse events occurred with a similarly low incidence in the 2 treatment groups.

CONCLUSIONS: This analysis confirms that bicalutamide provides benefit in patients with locally advanced disease. The current data suggest that early or adjuvant hormonal therapy for patients at low risk of disease progression, such as those with localized disease, is not appropriate.

Author List

Wirth MP, See WA, McLeod DG, Iversen P, Morris T, Carroll K, Casodex Early Prostate Cancer Trialists' Group

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Aged, 80 and over
Anilides
Antineoplastic Agents
Disease Progression
Double-Blind Method
Follow-Up Studies
Humans
Male
Middle Aged
Neoplasm Staging
Nitriles
Program Evaluation
Prospective Studies
Prostatic Neoplasms
Survival Rate
Time Factors
Tosyl Compounds