RANDOMIZED STUDY OF CASODEX 50 MG MONOTHERAPY VS ORCHIECTOMY IN THE TREATMENT OF METASTATIC PROSTATE-CANCER

The effect of Casodex (ICI 176,334), a new, once-daily, selective anti androgen, given as 50 mg monotherapy, was compared with orchidectomy i n a randomised, multicentre, open study in 376 patients with metastati c prostate cancer. At 3 months, PSA was reduced by 86% in the Casodex group and by 96% in the orchidectomy group. Treatment failed in 51 pat ients in the orchidectomy group and 66 showed a subjective response. T reatment failed in 86 patients treated with Casodex and 40 patients sh owed a subjective response. Patients treated with Casodex maintained t heir sexual interest better than those in the orchidectomy group. Medi an survival was significantly longer in the orchidectomy group. Casode x was well-tolerated. The most likely reason for the differences betwe en the groups regarding time to treatment failure and survival is that the dose of Casodex was too small. Further studies with higher doses of Casodex are in progress.