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Published on: March 6, 2018
Prolonged response to nilutamide in a patient with stage D0.5 prostate cancer who previously failed androgen
Nushin F Todd1, Ronald Lieberman, James L Gulley
1Laboratory of Tumor Immunology and Biology, Center for Cancer Research, National Cancer Institute, Bethesda, MD 20892, USA.
Abstract:
There is currently no standard therapy for patients with prostate cancer who have progressive rise in PSA levels despite treatment with hormonal ablation and antiandrogen withdrawal (stage D0.5). One potential treatment option is the use of a different androgen receptor antagonist (ARA), such as nilutamide. We report a case of a 66-year-old gentleman with greater than a 46 month sustained response to nilutamide therapy after failing bicalutamide therapy and its subsequent withdrawal. The patient continues to have undetectable PSA levels and an excellent performance status. This case demonstrates the prolonged response to a second-line ARA in patients deemed to have androgen insensitive prostate cancer. Further investigation of the potential role of nilutamide therapy as second-line antiandrogen therapy is warranted as monotherapy and/or in combination with other promising novel approaches including PSA-based vaccines.
Insights
For advanced prostate cancer, nilutamide offers a sustained response in patients resistant to other treatments. This androgen receptor antagonist shows promise as a second-line therapy for managing rising PSA levels.
Area of Science:
- Oncology
- Urology
Background:
- No standard therapy exists for prostate cancer with rising PSA after hormonal ablation and antiandrogen withdrawal (stage D0.5).
- Androgen receptor antagonists (ARAs) are a potential treatment option in such cases.
Observation:
- A 66-year-old male patient with advanced prostate cancer experienced a sustained response exceeding 46 months to nilutamide therapy.
- This response occurred after the patient failed prior bicalutamide therapy and its subsequent withdrawal.
- The patient maintained undetectable PSA levels and an excellent performance status throughout the treatment period.
Findings:
- Nilutamide demonstrated a prolonged efficacy as a second-line ARA in a patient with presumed androgen-insensitive prostate cancer.
- This case highlights the potential of nilutamide in managing treatment-resistant prostate cancer progression.
Implications:
- Further research into nilutamide as a second-line antiandrogen therapy, alone or in combination, is warranted.
- Nilutamide may offer a viable treatment option for patients with advanced prostate cancer who have exhausted other therapies.
