Combination therapy with flutamide and castration (LHRH agonist or orchiectomy) in advanced prostate cancer: A marked improvement in response and survival

Labrie, Fernand; Dupont, André; Bélanger, Alain; Giguère, M.; Lacoursiere, Y.; Emond, Jean; Monfette, G.; Bergeron, Vivianne

doi:10.1016/s0022-4731(85)80024-8

Cited by 152 publications

(57 citation statements)

References 24 publications

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“…Moreover, we demonstrated that approximately 25% of testosterone in prostate cancer tissue remained after castration [12]. These result suggested that ADT for prostate cancer requires not only surgical or medical castration using LH-RH analogue but also anti-androgen agents [13]. Anti-androgen agents have various mechanisms for blocking the activities of androgen (Fig.…”

Section: Combined Androgen Blockade Therapy In Prostate Cancermentioning

confidence: 71%

Primary combined androgen blockade in localized disease and its mechanism

Namiki¹,

Kitagawa²,

Mizokami³

et al. 2008

Best Practice & Research Clinical Endocrinology & Metab

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In spite of clinical practice guidelines such as NCI-PDQ in which primary androgen deprivation therapy (PADT) is not recommended as the primary treatment for localized prostate cancer, many patients have been treated with PADT. One of the reasons is that urologists themselves permit patients' desire because they knew the effectiveness of PADT for some patients in their experiences.In this review we demonstrated basic mechanisms and clinical efficacy of primary combined androgen blockade (PCAB) for localized or locally advanced prostate cancer.

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Section: Combined Androgen Blockade Therapy In Prostate Cancermentioning

confidence: 71%

Primary combined androgen blockade in localized disease and its mechanism

Namiki¹,

Kitagawa²,

Mizokami³

et al. 2008

Best Practice & Research Clinical Endocrinology & Metab

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“…No immediate recovery in serum hemoglobin, testosterone, or erythropoietin was observed upon completion of tab. effects on serum testosterone and hemoglobin 1,[7][8][9][10] . Recent studies have confirmed a decline in serum hemoglobin attributable to these newer approaches to tab-and also a variety of other side effects, including metabolic disorders, cardiovascular disease, hot flashes, sexual dysfunction, depressed mood, muscle weakness, and osteoporosis 2,7,[11][12][13][14][15][16][17] .…”

Section: Resultsmentioning

confidence: 99%

Effects of Radiation and Total Androgen Blockade on Serum Hemoglobin, Testosterone, and Erythropoietin in Patients with Localized Prostate Cancer

Golfam¹,

Samant²,

Eapen³

et al. 2012

Current Oncology

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Objective: The objective of the present study was to evaluate the incidence, time of onset, and extent of hemoglobin, testosterone, and erythropoietin changes in patients with localized prostate cancer receiving either radiation alone or radiation combined with total androgen blockade (tab). Methods: The study enrolled 35 patients (median age: 69 years) with clinically localized prostate cancer who received 3-dimensional conformal radiation with or without tab. Patients were generally treated with radiation alone (group 1), radiation plus short-term (≤6 months) tab (group 2), or radiation plus long-term (≥2 years) tab (group 3). Serum hemoglobin, testosterone, and erythropoietin in these patients were prospectively evaluated. Results: The mean baseline serum hemoglobin for group 1 (n = 20), group 2 (n = 6), and group 3 (n = 9) was 149 g/L, 153 g/L, and 143 g/L respectively. We observed no significant decline in serum hemoglobin, testosterone, or erythropoietin among patients treated with radiotherapy alone. A significant drop in serum testosterone was noted in the group 2 and 3 patients within 1 month (p < 0.001), reaching a plateau at approximately 6 months. That change was followed by a significant decline (p < 0.001) in serum hemoglobin at 3–6 months (137 g/L in group 2 and 129 g/L in group 3). We observed a small but statistically significant increase in serum erythropoietin (p < 0.001) of 8 U/L in group 2 and 4 U/L in group 3 after 6 months of tab. No immediate recovery in serum hemoglobin, testosterone, or erythropoietin was observed upon completion of tab. Conclusions: Although conformal radiotherapy alone for localized prostate cancer had no effect on serum hemoglobin, testosterone, or erythropoietin, tab led to a significant decline in testosterone, which was followed by decline in hemoglobin that was not a result of a deficiency of erythropoietin.

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“…5,29 It should be made clear that PSA alone is not a diagnostic test demonstrating the presence of prostate cancer. It is simply a red light indicating that the diagnosis of prostate cancer is a significant possibility which should be eliminated by other tests.…”

Section: Discussionmentioning

confidence: 99%

“…3,4 The recommendation of the USPSTF is all the more surprising that it is well recognized that in the absence of screening, a large proportion or the majority of men will be diagnosed at the advanced metastatic stage when the possibility of cure no longer exists and when the best treatments can, at best, offer a few months of prolongation of a difficult and painful life. 4,5 After discovering combined androgen blockade in the 1980s, 5 the first treatment shown to prolong life in prostate cancer in prospective and randomized trials using combination with non steroidal antiandrogens, [6][7][8][9] we realized that only a few months of life could be added in patients with metastatic disease using the best available treatment which we had just developed. We then decided to start in 1988 the first randomized and prospective trial of screening for prostate cancer with the hope of being able to diagnose the disease at the localized, asymptomatic and only potentially curable stage.…”

Section: Introductionmentioning

confidence: 99%

PSA screening for prostate cancer: why so much controversy?

Labrie

2013

Asian J Androl

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Since prostate cancer reaches the advanced and non curable stage in the absence of any specific symptom or sign, it seems reasonable to diagnose this cancer at an early and curable stage. Screening by prostate-specific antigen (PSA) has been the common technology used. The last follow-up of the first two prospective and randomized screening studies for prostate cancer, namely the Quebec and ERSPC (European Randomized Study of Screening for Prostate Cancer) clinical trials started in 1988 and 1991, respectively, have shown reductions of prostate cancer death of 62% (P,0.002) and 21% (P,0.001) (38% in the tenth and eleventh years of follow-up, P,0.003), respectively, while the PLCO (Prostate Lung Colorectal and Ovarian Cancer) screening trial reported no benefit. It has been estimated, however, that 85% of men in the planned 'non-screened' group of the US study have been screened. With such a serious flaw, the PLCO study does not have the statistical power to reach any valid conclusion. In the Quebec study, only 7.3% of men were screened in the control arm. The important benefit observed in the ERSPC study was achieved using a less than optimal 4-year PSA screening interval which misses a significant number of cancers while the Quebec study used the optimal 1-year interval. With proper information obtained from their physicians or otherwise using data collected only from the clinical trials having the required statistical power, men should be in a good position to decide about being or not being screened for prostate cancer.

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Combination therapy with flutamide and castration (LHRH agonist or orchiectomy) in advanced prostate cancer: A marked improvement in response and survival

Cited by 152 publications

References 24 publications

Primary combined androgen blockade in localized disease and its mechanism

Primary combined androgen blockade in localized disease and its mechanism

Effects of Radiation and Total Androgen Blockade on Serum Hemoglobin, Testosterone, and Erythropoietin in Patients with Localized Prostate Cancer

PSA screening for prostate cancer: why so much controversy?

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