COMBINATION THERAPY WITH FLUTAMIDE AND THE LHRH AGONIST [D-TRP(6), DES-GLY-NH(2)(10)]LHRH ETHYLAMIDE IN STAGE-C PROSTATIC-CARCINOMA

A series of 1 15 previously untreated patients displaying clinical sta ge C prostatic carcinoma with no evidence of distant metastases receiv ed combination therapy using the antiandrogen flutamide and the LH RH agonist [D-Trp6, des-Gly-NH210]LHRH ethylamide; the average follow-up was 3.9 years. Twenty-eight patients showed treatment failure with a p robability of disease-free survival of 91.2% at 2 years. Twenty patien ts died from prostate cancer and 10 from other causes, the survival pr obability being 93.4% at 2 years. Local control was achieved rapidly i n all patients. Urinary obstruction and hydronephrosis were corrected in all cases. When compared with data obtained after single endocrine therapy (orchiectomy or oestrogens) or radiotherapy, the treatment fai lure rate at 2 years was more than 3.0-fold lower after combination th erapy (8.8%) than monotherapy (28.4%). The death rate 2 years after th e start of combination therapy was 6.6% and was on average 22.2% (3.6- fold higher) in the studies using monotherapy (orchiectomy or oestroge ns) or radiotherapy. The present data suggest that treatment of prosta te cancer with combination therapy before clinical evidence of dissemi nation of disease permits more efficient control of local disease and a decreased rate of progression to metastatic disease.