Flutamide versus prednisone in patients with prostate cancer symptomatically progressing after androgen-ablative therapy: A phase III study of the European Organization for Research and Treatment of Cancer Genitourinary Group

Sophie D. Fossa, S. M. Brausi, S. Horenblas, R. R. Hall, J. W. Hetherington, N. Aaronson, L. De Prijck, L. Collette

Research output: Contribution to journalArticle

155 Citations (Scopus)

Abstract

Purpose: Time to progression (TTP), overall survival, and quality of life (QL) were compared in patients with hormone-resistant prostate cancer (HRPC) treated with prednisone (5 mg orally, four times a day) or flutamide (250 mg orally, three times a day). Patients and Methods: Symptomatic patients were randomized to receive either prednisone (101 patients) or flutamide (100 patients). Subjective response was assessed based on performance status, the use of analgesics, and the need to apply alternative palliative treatment. Prostate-specific antigen (PSA)-based biochemical response (≥ 50% reduction of baseline PSA) was recorded. At baseline and at 6-week intervals during follow-up, patients completed the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C-30. Results: There was no difference between the groups in median TTP (prednisone, 3.4 months; flutamide, 2.3 months) or overall survival (prednisone, 10.6 months; flutamide, 11.2 months). In the prednisone group, 56% of the patients experienced a subjective response, compared with 45% in the flutamide group (P = .18). The median response duration was 4.8 months for prednisone and 4.2 months for flutamide. A biochemical response was observed in 21% and 23% of the prednisone and flutamide groups, respectively. Gastrointestinal toxicity was the reason for trial discontinuation in seven patients receiving flutamide and two patients receiving prednisone. The QL assessment parameters favored the use of prednisone with statistically significant differences in pain, fatigue, role functioning, appetite loss, gastrointestinal distress, and overall QL. Conclusion: In symptomatic HRPC, treatment with prednisone or flutamide leads to similar rates of TTP and overall survival and no difference in subjective or biochemical response. The QL results favor the use of low-cost prednisone in patients with HRPC.

Original languageEnglish (US)
Pages (from-to)62-71
Number of pages10
JournalJournal of Clinical Oncology
Volume19
Issue number1
StatePublished - Jan 1 2001

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Urogenital Neoplasms
Flutamide
Prednisone
Androgens
Prostatic Neoplasms
Organizations
Research
Quality of Life
Therapeutics
Hormones
Prostate-Specific Antigen
Survival
Appetite
Palliative Care
Fatigue
Analgesics

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Flutamide versus prednisone in patients with prostate cancer symptomatically progressing after androgen-ablative therapy : A phase III study of the European Organization for Research and Treatment of Cancer Genitourinary Group. / Fossa, Sophie D.; Brausi, S. M.; Horenblas, S.; Hall, R. R.; Hetherington, J. W.; Aaronson, N.; De Prijck, L.; Collette, L.

In: Journal of Clinical Oncology, Vol. 19, No. 1, 01.01.2001, p. 62-71.

Research output: Contribution to journalArticle

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title = "Flutamide versus prednisone in patients with prostate cancer symptomatically progressing after androgen-ablative therapy: A phase III study of the European Organization for Research and Treatment of Cancer Genitourinary Group",
abstract = "Purpose: Time to progression (TTP), overall survival, and quality of life (QL) were compared in patients with hormone-resistant prostate cancer (HRPC) treated with prednisone (5 mg orally, four times a day) or flutamide (250 mg orally, three times a day). Patients and Methods: Symptomatic patients were randomized to receive either prednisone (101 patients) or flutamide (100 patients). Subjective response was assessed based on performance status, the use of analgesics, and the need to apply alternative palliative treatment. Prostate-specific antigen (PSA)-based biochemical response (≥ 50{\%} reduction of baseline PSA) was recorded. At baseline and at 6-week intervals during follow-up, patients completed the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C-30. Results: There was no difference between the groups in median TTP (prednisone, 3.4 months; flutamide, 2.3 months) or overall survival (prednisone, 10.6 months; flutamide, 11.2 months). In the prednisone group, 56{\%} of the patients experienced a subjective response, compared with 45{\%} in the flutamide group (P = .18). The median response duration was 4.8 months for prednisone and 4.2 months for flutamide. A biochemical response was observed in 21{\%} and 23{\%} of the prednisone and flutamide groups, respectively. Gastrointestinal toxicity was the reason for trial discontinuation in seven patients receiving flutamide and two patients receiving prednisone. The QL assessment parameters favored the use of prednisone with statistically significant differences in pain, fatigue, role functioning, appetite loss, gastrointestinal distress, and overall QL. Conclusion: In symptomatic HRPC, treatment with prednisone or flutamide leads to similar rates of TTP and overall survival and no difference in subjective or biochemical response. The QL results favor the use of low-cost prednisone in patients with HRPC.",
author = "Fossa, {Sophie D.} and Brausi, {S. M.} and S. Horenblas and Hall, {R. R.} and Hetherington, {J. W.} and N. Aaronson and {De Prijck}, L. and L. Collette",
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T2 - A phase III study of the European Organization for Research and Treatment of Cancer Genitourinary Group

AU - Fossa, Sophie D.

AU - Brausi, S. M.

AU - Horenblas, S.

AU - Hall, R. R.

AU - Hetherington, J. W.

AU - Aaronson, N.

AU - De Prijck, L.

AU - Collette, L.

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AB - Purpose: Time to progression (TTP), overall survival, and quality of life (QL) were compared in patients with hormone-resistant prostate cancer (HRPC) treated with prednisone (5 mg orally, four times a day) or flutamide (250 mg orally, three times a day). Patients and Methods: Symptomatic patients were randomized to receive either prednisone (101 patients) or flutamide (100 patients). Subjective response was assessed based on performance status, the use of analgesics, and the need to apply alternative palliative treatment. Prostate-specific antigen (PSA)-based biochemical response (≥ 50% reduction of baseline PSA) was recorded. At baseline and at 6-week intervals during follow-up, patients completed the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C-30. Results: There was no difference between the groups in median TTP (prednisone, 3.4 months; flutamide, 2.3 months) or overall survival (prednisone, 10.6 months; flutamide, 11.2 months). In the prednisone group, 56% of the patients experienced a subjective response, compared with 45% in the flutamide group (P = .18). The median response duration was 4.8 months for prednisone and 4.2 months for flutamide. A biochemical response was observed in 21% and 23% of the prednisone and flutamide groups, respectively. Gastrointestinal toxicity was the reason for trial discontinuation in seven patients receiving flutamide and two patients receiving prednisone. The QL assessment parameters favored the use of prednisone with statistically significant differences in pain, fatigue, role functioning, appetite loss, gastrointestinal distress, and overall QL. Conclusion: In symptomatic HRPC, treatment with prednisone or flutamide leads to similar rates of TTP and overall survival and no difference in subjective or biochemical response. The QL results favor the use of low-cost prednisone in patients with HRPC.

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