METASTATIC PROSTATE-CANCER PULMONARY NODULES - BENEFICIAL-EFFECTS OF COMBINATION THERAPY AND SUBSEQUENT WITHDRAWAL OF FLUTAMIDE

A case is presented of a middle-aged man suffering from stage D2 prost ate cancer with pulmonary metastases who responded favorably, first, t o endocrine combination therapy with the antiandrogen flutamide and an LHRH agonist for 5.5 years, and, second, to the subsequent withdrawal of Flutamide at the time of the progression of the disease. This case has several exceptional features: absence of bone metastases, pulmona ry metastatic nodules characterized as focal neuroendocrine differenti ation, and a positive response to antiandrogen withdrawal upon relapse of metastases after initial positive response. The concept of escape to androgen blockade and development of androgenic hypersensitivity is discussed. (C) 1994 Wiley-Liss, Inc.