Pure antiandrogens as monotherapy in prospective studies of prostatic carcinoma.

Three antiandrogens are or will soon be available for clinical use. Only Flutamide has been studied in monotherapy of prostatic cancer patients. The use of Flutamide is associated with significant side effects. However, previously potent patients usually remain potent under Flutamide monotherapy. The mechanism of retained potency is poorly understood. In phase II studies parameters which are usually used for determining response of prostatic cancer to endocrine treatment react favourably to Flutamide monotherapy. Since the long-term elevation of plasma testosterone may have an impact on stimulation of prostatic cancer cells, long-term results of studies are mandatory. Such results, unfortunately, are not available in the literature. The use of "pure" antiandrogens as monotherapy and their long-term effectiveness is therefore uncertain. If effectiveness could be proven, especially in comparison to other standard forms of endocrine treatment, the use of a "pure" antiandrogen, especially of a substance with very few side effects, may provide a better quality of life than standard treatment and may therefore be preferable.