Leuprolide with and without flutamide in advanced prostate cancer

Article Abstract:

Leuprolide is an analog of gonadotrophin-releasing hormone. The compound inhibits the hypothalamus from releasing substances that stimulate the production of male sex hormones by the interstitial cells of the testis. Flutamide, on the other hand, does not reduce the circulating levels of androgens. Rather, this nonsteroidal antiandrogen acts by inhibiting the binding of androgens within the nuclei of cells, thus interfering with the action of androgens. In a study of 603 patients with advanced prostate cancer, the combination of leuprolide with flutamide was shown to be more effective than the use of leuprolide by itself. The median time to disease progression was 16.9 months for the patients receiving both drugs, in contrast to 13.9 months for patients receiving leuprolide alone. This advantage was also observed in overall survival, which was 35.0 months and 27.9 months for the combination treatment and leuprolide alone, respectively. An interesting finding to come out of the present study was that of differences in disease characteristics apparently due to race. Black men experienced a shorter survival time, and black race was associated with several poor prognostic factors, including weight loss, anemia, and pain. The reason for these associations is not clear, but race should be included as a clinical variable in studies of prostate cancer therapy. (Consumer Summary produced by Reliance Medical Information, Inc.)

Demographic aspects, Drug therapy, Race

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A controlled trial of leuprolide with and without flutanide in prostatic carcinoma

Article Abstract:

Whether or not chemically blocking the action of male hormones makes the treatment of prostate cancer more effective was investigated. Six hundred and three men being treated for prostate cancer with leuprolide acetate, which inhibits the release of growth hormone, were evaluated in a randomized, double-blind test. Half the men also received flutamide, which blocks the action of male hormones. The flutamide-treated men survived 16.5 months without worsening of their cancer, compared with 13.9 months in men not treated with flutamide. Flutamide-treated men survived an average of 36 months, versus 28 months for untreated men. The differences in the progression of the cancers in treated and untreated men were particularly pronounced in men who had minimal disease and good physical performance, meriting further studies on these patients. The patients were most relieved during the first three months of flutamide treatment. During this period, leuprolide alone often causes the disease to flare-up painfully. It was concluded that, in patients with advanced prostate cancer, a combination of flutamide and leuprolide is preferable to treatment with leuprolide alone.

Testing, Physiological aspects, Testosterone, Cancer, Somatotropin, Chemotherapy, Chemotherapy, Combination, Combination chemotherapy

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Bilateral orchiectomy with or without flutamide for metastatic prostate cancer

Article Abstract:

The anti-androgen drug flutamide does not appear to improve survival in men with prostate cancer who have both testicles removed, a technique called bilateral orchiectomy. Castration is normally done because prostate cancer is stimulated by male hormones. Researchers randomly assigned 1,387 men with prostate cancer to have a bilateral orchiectomy plus flutamide or a placebo. Survival rates were similar in both groups and flutamide caused diarrhea and anemia in some men.

Care and treatment, Orchiectomy

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