Bicalutamide 150 mg as First-Line Monotherapy of Patients with Low and Intermediate Risk Prostatic Cancer

Prostate cancer is the most common cancer among men, except for skin cancer. At time of diagnosis, most cases of prostate cancers (93%) are diagnosed when the disease is confined to the prostate and nearby organs. Overall, most men who develop prostate cancer (99%) have a life expectancy of at least five years from the time of diagnosis. Ninety-eight percent (98%) of the patients have a 10 years life expectancy and 94% of them will survive for at least 15 years. However, for men diagnosed with prostate cancer that has spread to other parts of the body, the five-year survival rate drops to 28%. Prostate cancer is the second leading cause of cancer death in men in the United States [1]. In cancer care, multidisciplinary team, to create an overall treatment plan that combines different type of treatments is extremely important. Treatment options and recommendations depend on several factors, including the type and stage of cancer, possible side effects, and the patient’s preferences and overall health. The most common treatment options for prostate cancer are: active surveillance for early-stage cancer, surgery, radiation therapy, hormone therapy, chemotherapy, vaccine therapy, and getting care for symptoms and side effects. One of the possible treatment options offered to patients is monotherapy by bicalutamide 150 mg/day. Bicalutamide is a non-steroidal pure anti androgen given at a dosage of 150 mg once daily as monotherapy for the treatment of early (localized or locally advanced) non-metastatic prostate cancer. The efficacy and tolerability of bicalutamide as monotherapy for patients with non-metastatic and metastatic prostate cancer have been evaluated in randomized clinical trials. Combined data from 2 studies revealed no statistically significant difference in overall survival between bicalutamide 150-mg monotherapy and castration in patients with non-metastatic locally advanced disease. In patients with metastatic disease, there was a statistically significant difference (6 weeks) in overall survival in favor of castration [2,3]. In the number of countries, bicalutamide 150 mg/day is approved in men with locally advanced non-metastatic prostate cancer as immediate therapy either as an Abstract Introduction: Bicalutamide (Casodex) is a competitive androgen receptor antagonist that inactivates androgen-regulated prostate cell growth and function, leading to cell apoptosis and inhibition of prostate cancer growth. In several countries, Bicalutamide 150 mg/day is approved in men with locally advanced non-metastatic prostate cancer as immediate therapy either in adjuvant setting, or as an alternative to surgical or medical castration.