Intermittent, low-dose, antiandrogen monotherapy as an alternative therapeutic option for patients with positive surgical margins after radical prostatectomy / 亚洲男科学杂志(英文版)

The aim of the present study was to determine whether oncologic outcomes and adverse events associated with active on/off intermittent antiandrogen monotherapy (daily bicalutamide, 50 mg per day) are comparable with those of standard external beam radiation therapy (EBRT) or combined androgen blockade (CAB) therapy in prostate cancers with positive surgical margins after radical prostatectomy. Two hundred twenty-three patients with positive surgical margins post-radical prostatectomy who underwent active surveillance (AS, n = 32), EBRT without hormone therapy (n = 55), intermittent antiandrogen monotherapy without EBRT (IAAM, n = 50), or CAB without EBRT (n = 86), between 2007 and 2014, were reviewed retrospectively. Pathologic outcomes, biochemical recurrence rates, radiological disease progression, and adverse events were collected from medical records. Biochemical recurrence rates, biochemical recurrence-free survival rates, and radiological recurrence were not different between the groups (P = 0.225, 0.896, and 0.284, respectively). Adverse event rates and severities were lower for IAAM compared with EBRT or CAB (both P < 0.05), but were comparable to those for AS (P = 0.591 and 0.990, respectively). Grade ≥3 adverse events were not reported in the IAAM or AS groups. Erectile dysfunction and loss of libido rates were lower in the IAAM group compared with the EBRT and CAB groups (P = 0.032). Gastrointestinal complications were more frequently reported in the EBRT group (P = 0.008). Active on/off IAAM treatment might be an appropriate treatment option for patients with positive surgical margins after radical prostatectomy. Furthermore, regarding oncologic outcomes, IAAM was comparable to standard EBRT but had a milder adverse event profile.

Medullary thyroid carcinoma - Adverse events during systemic treatment: risk-benefit ratio

ABSTRACT Medullary thyroid carcinoma (MTC) is a rare neuroendocrine tumor originating from parafollicular C cells of the thyroid and associated with mutations in the proto-oncogene REarranged during Transfection (RET). The prognosis of MTC depends on clinical stage, with a 95.6% 10-year survival rate among patients with localized disease and 40% among patients with advanced disease. Standard chemotherapy and radiotherapy have no significant impact on the overall survival of these patients and two tyrosine kinase receptor inhibitors (TKIs), vandetanib and cabozantinib, have been recently approved for the systemic treatment of locally advanced or metastatic MTC. However, since patients with MTC and residual or recurrent disease may have an indolent course with no need for systemic treatment, and since these drugs are highly toxic, it is extremely important to select the patients who will receive these drugs in a correct manner. It is also essential to carefully monitor patients using TKI regarding possible adverse effects, which should be properly managed when occurring.

Neumonía intersticial inducida por bloqueo androgénico máximo como tratamiento de cáncer de próstata avanzado: Report of one case / Fatal interstitial lung disease associated with maximum androgen blockade

Maximum androgen blockade is the standard endocrine treatment for advanced prostate cancer. Interstitial lung disease in different degrees of severity, with low mortality and excellent response to treatment may appear with its use. We report a 77 years old patient with advanced prostate cancer who developed severe and progressive respiratory failure associated to bilateral pulmonary infiltrates, attributed to the direct effect of maximum androgen blockade. Despite the therapeutic efforts, the patient died. Lung pathology revealed Usual Interstitial Pneumonia.

Histomorphometric study of effects of bicalutamide on spermatogenesis in male rats

To study the effects of Bicalutamide on spermatogenesis in male rats. Laboratory based randomized controlled trial. Anatomy Department, Armed Forces Postgraduate Medical Institute [AFPGMI], Rawalpindi in collaboration with National Veterinary Laboratories [NVL], Islamabad from April 2008 to May 2008. Forty adult male Sprague Dawley rats weighing 200-300 grams were randomly divided into two groups, Group A and Group B, each consisting of 20 animals each. Group A was taken as control group and was administered 5 cc of distilled water orally daily for 24 days while group B [Experimental group] was given 5 cc of distilled water daily containing bicalutamide 10 mg/ kg/ day for 24 days. All the animals were sacrificed on the next day after the last dose. The testes were removed and fixed in 10% formalin and then processed for paraffin embedding. Five micron thick sections were made. Haematoxylin, Eosin and PAS stains were used. Histomorphometric analysis was done and parameters, including the tubular diameter, height of seminiferous epithelium and germ cell count were noted. Statistically significant differences were found in tubular diameter, height of seminiferous epithelium and germ cell count in testes of experimental group when compared with the control group. The results showed that the mean tubular diameter, the height of the germinal epithelium of the seminiferous tubules and the number of germ cells were significantly reduced in by the experimental group showing that bicalutamide suppresses spermatogenesis in the Sprague - Dawley rats