Related Experiment Videos
Withdrawal phenomenon with the antiandrogen casodex
1Department of Urology, Lahey Clinic, Burlington, Massachusetts 01805.
The Journal of Urology
|March 1, 1995
Summary
Withdrawal of casodex (an antiandrogen) in prostate cancer patients showed favorable responses, including PSA declines. This suggests sustained antiandrogen exposure, not just low androgen levels, drives the withdrawal effect.
Area of Science:
- Oncology
- Urology
- Pharmacology
Background:
- Total androgen blockade is standard for metastatic prostate cancer.
- Flutamide withdrawal syndrome is a known phenomenon in patients progressing on combined therapy.
- The role of withdrawing newer antiandrogens like casodex is less understood.
Observation:
- Three patients with progressive prostate cancer on casodex monotherapy, later combined with luteinizing hormone-releasing hormone analogues, underwent casodex withdrawal.
- Patients had previously progressed on initial casodex monotherapy.
- Disease progression was monitored via prostate-specific antigen (PSA) and bone scans.
Findings:
- Two of three patients experienced significant prostate-specific antigen (PSA) declines (42% and 75%) lasting 3-6 months after casodex withdrawal.
- One patient remained stable for 2 months.
- Responses resembled those seen with flutamide withdrawal.
Implications:
- Sustained exposure to an antiandrogen, like casodex, may be crucial for inducing the withdrawal phenomenon.
- This contrasts with the hypothesis that a low androgen environment alone is sufficient.
- Antiandrogen withdrawal could be a therapeutic option for select prostate cancer patients.