[Does total androgen suppression in advanced prostatic cancer induce a greater number of complete remissions? A phase...

The present Phase II study's main objective was to evaluate the rate of complete responses (CR) obtained through total androgenic suppression (TAS) in patients with disseminated prostate carcinoma. Twenty consecutive patients were recruited of which 19 were evaluable for response and toxicity. Treatment consisted in an association of orchiectomy or the analogous LH-RH Buselerin with the antiandrogenic Flutamide. There was 1 CR (5%) and 17 partial responses (PR). Sixteen patients with symptomatic disease had subjective improvement, usually during the first month of treatment. After an average follow-up of 20 months (range 7-29), 1 patient remains CR and 7 have regressed following PR, 4 of which have died. Tolerance was good, and side effects secondary to hypoandrogenism were frequent, although mild, requiring treatment discontinuation in 1 case. It is concluded that TAS is an excellent palliative approach in disseminated prostate carcinoma though the rate of CRs obtained is sensibly lower to that reported by Labrie (28.3%) and in the range of 0-8% achieved in most studies. It is questionable whether it will become standard therapy for metastatic prostate carcinoma.