Bicalutamide helpful in locally advanced prostate cancer

Oral bicalutamide treatment added to standard care improves survival in patients with locally advanced prostate cancer, European researchers report in the November issue of the Journal of Urology.

Dr. Peter Iverson of the University of Copenhagen and colleagues, randomized 1218 men with localized or locally advanced prostate cancer to receive oral bicalutamide 150 mg daily or placebo in addition to radical prostatectomy, radiotherapy or watchful waiting.At a median follow-up of 5.3 years, there was no significant difference in overall survival. However, bicalutamide patients with locally advanced disease showed a trend towards improved survival (hazard ratio 0.68). Those with localized disease had a trend towards reduced survival (hazard ratio 1.47).Nevertheless, the agent provided a significant increase in progression free survival (43%). Patients with locally advanced disease gained the greatest benefit (hazard ratio 0.40).The researchers point out that because most (81%) of the enrolled patients were untreated and would have undergone watchful waiting, the results essentially reflect the effect of hormone therapy compared to watchful waiting.The investigators conclude that in patients with locally advanced disease, bicalutamide provides significant benefits. However, in other untreated patients, such an approach may lead to “no benefit or may even decrease survival.”(Source: J Urol 2004;172:1871-1876: Reuters Health: Oncolink: November 2004.)