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

J Steroid Biochem. 1985 Nov;23(5B):833-41. doi: 10.1016/s0022-4731(85)80024-8.

Abstract

Eighty-seven previously untreated patients with clinical stage D2 (bone metastases) prostate cancer have received the combination therapy with a pure antiandrogen and an LHRH agonist (or orchiectomy) as first treatment in a multicentre study for up to 34 months (average = 16.2 months). A positive objective response assessed according to the criteria of the US NPCP has been observed in all cases. Pain disappeared in all patients within 1 month and performance become normal in all (including 2 bedridden patients) within 4 months. Progression of the disease after a period of remission has been observed in only 8 patients. Only one patient has died from prostate cancer while 3 have died from other causes. The probability of continuing response and survival at 2 years for the patients who receive the combination treatment (Kaplan-Meier's method) is 81 and 91%, respectively. By contrast, in the randomized group who had orchiectomy alone, 4 of 7 have died from prostate cancer (P less than 0.05 as compared to combination therapy). In addition to a marked improvement in the remission rate and survival, combination therapy maintains a good quality of life, hot flashes and a decrease or loss of libido being the only side-effects.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Acid Phosphatase / blood
  • Anilides / therapeutic use*
  • Bone Neoplasms / diagnostic imaging
  • Bone Neoplasms / secondary
  • Bone and Bones / diagnostic imaging
  • Dehydroepiandrosterone / analogs & derivatives
  • Dehydroepiandrosterone / blood
  • Dehydroepiandrosterone Sulfate
  • Drug Therapy, Combination
  • Flutamide / therapeutic use*
  • Gonadotropin-Releasing Hormone / analogs & derivatives*
  • Gonadotropin-Releasing Hormone / therapeutic use
  • Humans
  • Male
  • Orchiectomy*
  • Prostatic Neoplasms / drug therapy*
  • Prostatic Neoplasms / mortality
  • Radionuclide Imaging
  • Testosterone / blood

Substances

  • Anilides
  • Gonadotropin-Releasing Hormone
  • Testosterone
  • Dehydroepiandrosterone
  • Dehydroepiandrosterone Sulfate
  • Flutamide
  • Acid Phosphatase