Alternation of non-steroidal antiandrogens for progressive prostate cancer following maximum androgen blockade - Results of non-steroidal antiandrogen sequential alternation for prostate cancer (NASA-PC) study group

Naohiro Fujimoto, Tetsuro Matsumoto, Hiroyoshi Suzuki, Tomohiko Ichikawa, Koji Okihara, Tsuneharu Miki, Hideaki Miyake, Masato Fujisawa, Motohide Uemura, Susumu Miyoshi, Takatoshi Tacho, Akira Yano, Motohiro Fujii, Yoshio Takihana, Masayuki Takeda, Mitsuhiro Seki, Akio Matsubara, Tsuguru Usui, Hidefumi Kinoshita, Tadashi Matsuda & 5 others Soichi Mugiya, Seiichiro Ohzono, Yasutomo Nasu, Takashi Saika, Hiromi Kumon

Research output: Contribution to journalArticle

Abstract

Prostate cancer is an androgen-dependent tumor and initially responds well to hormone therapy. However, objective and biochemical progression generally ensue following successful hormone therapy, especially in patients with advanced prostate cancer. Cancer in this stage is described as hormone-refractory prostate cancer. Even at this stage, a subset of prostate cancer cells can still be hormonally dependent. For patients with androgen-independent but hormone-sensitive cancer cells, secondary hormone manipulation is active and can be expected to improve the prognosis. We herein report the results of sequential use of non-steroidal antiandrogens for patients with progression following first-line maximum androgen blockade (MAB) and we review the literature. Retrospective analysis was carried out for 232 patients with advanced prostate cancer (stages C and D) who received alternation of non-steroidal antiandrogens after progression following first-line MAB. A greater than 50% decrease in PSA was observed in 34.2% and 43.6% by switching from bicalutamide to flutamide and from flutamide to bicalutamide, respectively. As a whole, in 35.8% (83/232), PSA decreased by more than 50%. Some decrease in PSA was observed in 61.2% and those responders showed significantly better survival than the non-responders. The duration of the response to the second-line MAB was more than 202 days. The patients who received alternation of antiandrogens before the level of PSA rose to 4.0 ng/ml showed a better response to the second-line therapy. Both the present study and previous reports demonstrate that the response rates to the alternation of antiandrogens are 20-50% and this indicates that alternative antiandrogens offer some benefit for patients with relapse following first-line MAB. (Nishinihon J. Urol. 71: 3-10,2009).

Original languageEnglish
Pages (from-to)3-10
Number of pages8
JournalNishinihon Journal of Urology
Volume71
Issue number1
Publication statusPublished - Jan 2009

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Androgen Antagonists
Androgens
Prostatic Neoplasms
Hormones
Flutamide
Neoplasms
Therapeutics
Recurrence
Survival

Keywords

  • Alternation therapy
  • Antiandrogen
  • Hormone-refractory prostate cancer

ASJC Scopus subject areas

  • Urology

Cite this

Alternation of non-steroidal antiandrogens for progressive prostate cancer following maximum androgen blockade - Results of non-steroidal antiandrogen sequential alternation for prostate cancer (NASA-PC) study group. / Fujimoto, Naohiro; Matsumoto, Tetsuro; Suzuki, Hiroyoshi; Ichikawa, Tomohiko; Okihara, Koji; Miki, Tsuneharu; Miyake, Hideaki; Fujisawa, Masato; Uemura, Motohide; Miyoshi, Susumu; Tacho, Takatoshi; Yano, Akira; Fujii, Motohiro; Takihana, Yoshio; Takeda, Masayuki; Seki, Mitsuhiro; Matsubara, Akio; Usui, Tsuguru; Kinoshita, Hidefumi; Matsuda, Tadashi; Mugiya, Soichi; Ohzono, Seiichiro; Nasu, Yasutomo; Saika, Takashi; Kumon, Hiromi.

In: Nishinihon Journal of Urology, Vol. 71, No. 1, 01.2009, p. 3-10.

Research output: Contribution to journalArticle

Fujimoto, N, Matsumoto, T, Suzuki, H, Ichikawa, T, Okihara, K, Miki, T, Miyake, H, Fujisawa, M, Uemura, M, Miyoshi, S, Tacho, T, Yano, A, Fujii, M, Takihana, Y, Takeda, M, Seki, M, Matsubara, A, Usui, T, Kinoshita, H, Matsuda, T, Mugiya, S, Ohzono, S, Nasu, Y, Saika, T & Kumon, H 2009, 'Alternation of non-steroidal antiandrogens for progressive prostate cancer following maximum androgen blockade - Results of non-steroidal antiandrogen sequential alternation for prostate cancer (NASA-PC) study group', Nishinihon Journal of Urology, vol. 71, no. 1, pp. 3-10.
Fujimoto, Naohiro ; Matsumoto, Tetsuro ; Suzuki, Hiroyoshi ; Ichikawa, Tomohiko ; Okihara, Koji ; Miki, Tsuneharu ; Miyake, Hideaki ; Fujisawa, Masato ; Uemura, Motohide ; Miyoshi, Susumu ; Tacho, Takatoshi ; Yano, Akira ; Fujii, Motohiro ; Takihana, Yoshio ; Takeda, Masayuki ; Seki, Mitsuhiro ; Matsubara, Akio ; Usui, Tsuguru ; Kinoshita, Hidefumi ; Matsuda, Tadashi ; Mugiya, Soichi ; Ohzono, Seiichiro ; Nasu, Yasutomo ; Saika, Takashi ; Kumon, Hiromi. / Alternation of non-steroidal antiandrogens for progressive prostate cancer following maximum androgen blockade - Results of non-steroidal antiandrogen sequential alternation for prostate cancer (NASA-PC) study group. In: Nishinihon Journal of Urology. 2009 ; Vol. 71, No. 1. pp. 3-10.
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AU - Matsumoto, Tetsuro

AU - Suzuki, Hiroyoshi

AU - Ichikawa, Tomohiko

AU - Okihara, Koji

AU - Miki, Tsuneharu

AU - Miyake, Hideaki

AU - Fujisawa, Masato

AU - Uemura, Motohide

AU - Miyoshi, Susumu

AU - Tacho, Takatoshi

AU - Yano, Akira

AU - Fujii, Motohiro

AU - Takihana, Yoshio

AU - Takeda, Masayuki

AU - Seki, Mitsuhiro

AU - Matsubara, Akio

AU - Usui, Tsuguru

AU - Kinoshita, Hidefumi

AU - Matsuda, Tadashi

AU - Mugiya, Soichi

AU - Ohzono, Seiichiro

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