The role of antiandrogen monotherapy in the treatment of prostate cancer

  title={The role of antiandrogen monotherapy in the treatment of prostate cancer},
  author={J. B. Anderson},
  journal={BJU International},
  • J. Anderson
  • Published 26 February 2003
  • Medicine, Biology
  • BJU International
The mainstay of hormonal therapy in prostate cancer has been medical or surgical castration, both of which are associated with loss of libido and impotence, and may not always be acceptable to the patient. Antiandrogen monotherapy is an alternative treatment option to castration. There are two types of antiandrogen, i.e. steroidal (cyproterone acetate, CPA), and nonsteroidal (bicalutamide, flutamide and nilutamide). Data comparing survival outcome with CPA and castration are limited and… 

Antiandrogen treatments in locally advanced prostate cancer: are they all the same?

  • D. Gillatt
  • Medicine, Biology
    Journal of Cancer Research and Clinical Oncology
  • 2006
The available evidence indicates that the different antiandrogens should not be regarded as equivalents in clinical practice and so the choice of treatment for patients with prostate cancer should be made on an individual basis.


This randomized study of CPA and castration in patients with metastatic prostate cancer has not so far revealed any significant differences in progression-free survival, which encourages us to comment that this therapy is safe and acceptable.

Androgen deprivation therapy: past, present and future

The most extensively studied antagonist, degarelix, avoids the testosterone surge and clinical flare associated with LHRH agonists, offering more rapid PSA and testosterone suppression, improved testosterone control and improved PSA progression‐free survival compared with agonists.

First-Line Hormonal Manipulation: Surgical and Medical Castration with LHRH Agonists and Antagonists, Steroids, and Pure Antiandrogens

The gold standard of ADT alone as first-line therapy may well be modified soon thanks to study findings published in 2015 that so far show – at least for patients with metastatic carcinoma of the prostate – statistically significant and clinically relevant advantages of first- line therapy ofADT combined with chemotherapy rather than ADTalone alone.

Hormonal therapy and chemotherapy for advanced prostate cancer

Recently reported results of clinical trials have given answers to questions regarding the best therapeutic agents and strategies, and these have broadened the scope of evidence-based therapy in this field.

Hormonal Therapy in Metastatic Prostate Cancer: Current Perspectives and Controversies

This review assesses the present status of hormonal therapy in metastatic prostate cancer and specifically deals with those aspects of androgen ablation therapy that are still a subject of debate.



Is there a role for antiandrogen monotherapy in patients with metastatic prostate cancer?

Patients with a higher disease burden (PSA >400 ng/ml) may decide that quality of life and symptomatic benefits outweigh the slight survival disadvantage seen in clinical trials and opt for bicalutamide monotherapy as an alternative to castration.

Clinical Pharmacokinetics of the Antiandrogens and Their Efficacy in Prostate Cancer

It is not yet clear if antiandrogen are of any benefit in downstaging the extent of disease before prostatectomy and/or radiotherapy, but some evidence exist that pure antiandrogens improve survival if combined with other forms of castration.

Nilutamide: An Antiandrogen for the Treatment of Prostate Cancer

Nilutamide does not appear to represent a major advance in the treatment of advanced prostate cancer and appears to be somewhat inferior to both flutamide and bicalutamide with regard to adverse effects.

Antiandrogens: a summary review of pharmacodynamic properties and tolerability in prostate cancer therapy.

The bicalutamide, due to its better tolerability profile, together with its once-daily oral administration regimen, could be considered the antiandrogen of first choice in the treatment of prostatic cancer.

Nonsteroidal antiandrogens: a therapeutic option for patients with advanced prostate cancer who wish to retain sexual interest and function

In the absence of sexual interest, the treatment of sexual dysfunction becomes less relevant and therefore hormonal treatments for advanced prostate cancer which spare sexual interest are needed.

Bicalutamide monotherapy versus flutamide plus goserelin in prostate cancer patients: results of an Italian Prostate Cancer Project study.

Bicalutamide monotherapy yielded comparable results relative to standard treatment with MAB, induced fewer side effects, and produced a better QOL.

Double-blind, randomized study of primary hormonal treatment of stage D2 prostate carcinoma: flutamide versus diethylstilbestrol.

  • A. ChangB. Yeap D. Trump
  • Medicine
    Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • 1996
As the primary hormonal therapy for stage D2 prostate cancer, DES caused more serious cardiovascular or thromboembolic complications than flutamide, andFlutamide was not as active an initial agent as DES, however, the effectiveness of flutamia in conjunction with other agents compared with DES remains undetermined.