“Pamidronate to Prevent Bone Loss During Androgen-Deprivation Therapy for Prostate Cancer”
Matthew R. Smith, M.D., Ph.D., Francis J. McGovern, M.D., Anthony L. Zietman, M.D., Mary Anne Fallon, L.P.N., Douglas L. Hayden, M.A., David A. Schoenfeld, Ph.D., Philip W. Kantoff, M.D., and Joel S. Finkelstein, M.D.
The purpose of this study was to
determine whether a gonadotropin-releasing
hormone agonist would prevent osteoporosis
in men with prostate
cancer. Here 47 patients with advanced or recurrent
prostate cancer without bone
metastasis were assigned to receive
either leuprolide alone or leuprolide and pamidronate
combined. Those who completed the study consisted of
41 patients. After 48 weeks physicians found substantial
differences in bone
mineral density between the two types
of hormone therapies administered. Patients receiving
leuprolide alone averaged a bone mineral density decrease
of 3.3 percent in the lumbar spine, 2.1 percent in the
trochanter, and 1.8 percent in the total hip. In contrast,
patients treated with leuprolide and pamidronate experienced
no significant bone mineral density changes at any skeletal
“Alternative Antiandrogens to Treat Prostate Cancer Relapse After Initial Hormone Therapy”
KOJIMA, SATOKO; SUZUKI, HIROYOSHI *; AKAKURA, KOICHIRO; SHIMBO, MASAKI; ICHIKAWA, TOMOHIKO; ITO, HARUO Journal of Urology. 171(2): 679-683, February 2004.
In this study 70 patients with advanced
prostate cancer were treated with hormone
therapy, androgen deprivation monotherapy,
or maximum androgen blockade including surgical or medical
castration combined with steroidal antiandrogen. Doctors
discontinued antiandrogen stopped responding to treatments.
Patients were then evaluated for withdrawal effects.
Soon after doctors administered an alternative antiandrogen.
At first line hormonal therapy 35.8 percent of patients
exhibited an incidence of withdrawal, 8.0 percent at
second line, and 0 percent at third line. An effective
alternative in second line or third line hormone therapy
is nonsteroidal antiandrogens.
“Hormone Therapy for Locally Advanced Prostate Cancer”
FOWLER, JACKSON E. JR. *; BIGLER, STEVEN A.; WHITE, PAIGE C.; DUNCAN, WILLIAM L. Journal of Urology. 168(2):546-549, August 2002.
This study evaluated 208 patients
with locally advanced prostate cancer who were treated
between February 1991 and November 2000 with gonadal
androgen ablation or gonadal androgen ablation and an
antiandrogen. Patients had an average PSA level of 46ng/mL.
Doctors tracked them at approximately 78 months and
conducted observations at 46 months. Fourteen patients
(7 percent) died of causes related to cancer and 71
patients (34 percent) died of associative diseases.
The rate of cause-specific survival was heavily influenced
by having a Gleason score less than 8 or greater than
8. At five years all cause survival was 59 percent and
at eight years it was 41 percent. Complications from
the primary tumor developed in 13 patients (6 percent)
and included obstructive symptoms, which required a
prostate resection, a ureteral obstruction,
or persistent hematuria.
Complications from treatment developed in four patients
and included flutamide hepatotocicity
and a hip fracture.