Advertisement

Complete Remission of Metastatic Carcinoma of the Prostate with Bicalutamide Withdrawal

      This paper is only available as a PDF. To read, Please Download here.

      Abstract

      An 83-year-old man was diagnosed with stage 4 prostate cancer with a Gleason score of 7 (3+4). His Initials prostate-specific antigen (PSA) level was 965 ng/dL, and he demonstrated extensive metastatic disease of the thoracic spine. After an Initials response to monthly leuprolide injections, his PSA level began to increase and bicalutamide was added. An Initials decrease in his PSA level was observed; however, the level gradually rose to 212 ng/dL and bicalutamide was discontinued. Three months later, his PSA level was < 0.05 ng/dL and has remained < 1 ng/dL for the past 27 months. Bicalutamide withdrawal usually leads to transient remission, with PSA level dropping to approximately 50% of the Initials level. The duration of the remission is usually limited to approximately 6 months. However, the sustained response that was observed in our patient suggests that a trial of androgen withdrawal, even in the setting of rising PSA levels, might be reasonable before initiating more toxic therapies.

      Key words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Clinical Genitourinary Cancer
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Paul R
        • Breul J
        Antiandrogen withdrawal syndrome associated with prostate cancer therapies: incidence and clinical significance.
        Drug Saf. 2000; 23: 381-390
        • Taplin ME
        • Rajeshkumar B
        • Halabi S
        • et al.
        Androgen receptor mutations in androgen-independent prostate cancer: Cancer and Leukemia Group B study 9663.
        J Clin Oncol. 2003; 21: 2673-2678
        • Small EJ
        • Halabi S
        • Kantoff P
        • et al.
        Activities and accomplishments of the Cancer and Leukemia Group B Genitourinary Committee.
        Clin Cancer Res. 2006; 12: 3596s-3600s
        • El-Gabry EA
        • Strup SE
        • Gomella LG
        Undetectable prostate-specific antigen response with bicalutamide withdrawal phenomenon.
        Tech Urol. 2000; 6: 221-222
        • Nelson WG
        • De Marzo AM
        • Isaacs WB
        Prostate cancer.
        N Engl J Med. 2003; 349: 366-381
        • Scher HI
        • Liebertz C
        • Kelly WK
        • et al.
        Bicalutamide for advanced prostate cancer: the natural versus treated history of disease.
        J Clin Oncol. 1997; 15: 2928-2938