[The role of bicalutamide in the treatment of prostate cancer]

Abstract

Bicalutamide is an effective, non-steroidal antiandrogen, suitable for oral, once daily administration. Bicalutamide 50 mg plus LHRHa is at least as effective as flutamide plus LHRHa in terms of survival and time to progression. Monotherapy with bicalutamide 150 mg once daily has similar survival rates compared with castration in advanced non-metastatic disease. Current clinical trials are evaluating the efficacy of bicalutamide as monotherapy in the setting of adjuvant therapy in early stage disease. Sexual interest appears to be better preserved with bicalutamide than with castration. Breast pain and gynecomastia are the most common side effects. Bicalutamide is not associated with interstitial pneumonitis and difficulty with light/dark adaptation seen with nilutamide, and in 50 mg/day dosage causes a lower incidence of diarrhea than flutamide 750 mg/day. Changes in hepatic function are usually transient and resolve or improve during therapy or after bicalutamide treatment is withdrawn.