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The non-steroidal antiandrogen, bicalutamide ('Casodex'), may preserve bone mineral density as compared with castration: results of a preliminary study

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Abstract

The impact of bicalutamide (Casodex) monotherapy on bone mineral density (BMD) was investigated in patients with locally advanced prostate cancer. BMD was assessed after treatment with bicalutamide 150 mg daily (n=21) or by medical castration (goserelin acetate 3.6 mg every 28 days) (n=8) for a median of 287 weeks. In 38% of castration compared with 17% of bicalutamide patients, femoral neck Z-scores were ≤−1 SD of the reference value (accepted as a two to three times increased risk of fracture) and T-scores were ≤−2.5 SD (World Health Organization definition of osteoporosis in white females). Total hip Z-scores were ≤−1 in 43% of castration patients and 13% of bicalutamide patients. In 38% of patients, lumbar spine BMD was affected by degenerative disease. These preliminary data suggest that there may be an advantage in terms of BMD in using bicalutamide monotherapy compared with castration; a benefit confirmed in a recent prospective randomised study.

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Acknowledgements

The authors would like to acknowledge the contribution of the following investigators in study 176334/0306. Sweden: Dr. P.-A. Abrahamsson, Professor J.-E. Damber, Dr. R. Stege. Norway: Professor P.A. Hoisaeter, Dr. R. Mortensen/Dr. l. Hoem. Finland: Dr. O. Hynninen, Dr. T. Kylmala, Dr. O. Lukkarinen, Dr. E. Rintala, Dr. K. Tuhkanen. The authors would like to acknowledge the contribution of the following investigators in study 176334/0307. Belgium: Professor L. Denis/Dr. P. Van Erps, Professor C. Schulman, Professor P. Van Cangh. South Africa: Professor J.P. Jordaan.

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Authors and Affiliations

  1. Clinical Trials Unit, Plymouth Oncology Centre, Plymouth, PL6 8DH, UK

    C. J. Tyrrell

  2. Department of Nuclear Medicine, Guy's Hospital, London, UK

    G. M. Blake

  3. Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

    P. Iversen

  4. Royal Free Hospital, London, UK

    A. V. Kaisary

  5. AstraZeneca Pharmaceuticals, Alderley Park, Macclesfield, UK

    I. Melezinek

Authors
  1. C. J. Tyrrell
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  2. G. M. Blake
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  3. P. Iversen
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  4. A. V. Kaisary
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  5. I. Melezinek
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Correspondence to C. J. Tyrrell.

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Casodex is a trademark of the AstraZeneca group of companies

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Tyrrell, C.J., Blake, G.M., Iversen, P. et al. The non-steroidal antiandrogen, bicalutamide ('Casodex'), may preserve bone mineral density as compared with castration: results of a preliminary study. World J Urol 21, 37–42 (2003). https://doi.org/10.1007/s00345-003-0322-7

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  • DOI: https://doi.org/10.1007/s00345-003-0322-7

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