Combination studies with leuprolide

The effectiveness of leuprolide (an LHRH analog), alone or in combination with flutamide (a non-steroidal antiandrogen) was tested in a double-blind multicenter study involving 603 patients with advanced prostatic cancer. The estimated median survival time was significantly longer in the patients who received combination therapy (35 months vs. 27.9 months), as was the median time to progression (16.9 months vs. 13.9 months). The beneficial effects of combination therapy were most marked in the subgroup of patients with minimal disease and good performance status. Black patients tended to have a shorter survival time than white patients. Both treatments were well tolerated. These results suggest that there are therapeutic advantages in combining medical castration using LHRH analogs with antiandrogens to suppress the actions of adrenal androgens.