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 prostate cancer with pulmonary metastases who responded favorably, first, to 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, pulmonary metastatic nodules characterized as focal neuroendocrine differentiation, 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. © 1994 Wiley‐Liss, Inc.

[1]  M. Koutsilieris,et al.  Response to flutamide withdrawal in advanced prostate cancer in progression under combination therapy. , 1993, The Journal of urology.

[2]  H. Scher,et al.  Prostate specific antigen decline after antiandrogen withdrawal: the flutamide withdrawal syndrome. , 1993, The Journal of urology.

[3]  F. Labrie.  Endocrine therapy for prostate cancer. , 1991, Endocrinology and metabolism clinics of North America.

[4]  G. Jenster,et al.  A mutation in the ligand binding domain of the androgen receptor of human LNCaP cells affects steroid binding characteristics and response to anti-androgens. , 1990, Biochemical and biophysical research communications.

[5]  R. Cohen,et al.  Prostatic carcinoma: histological and immunohistological factors affecting prognosis. , 1990, British journal of urology.

[6]  P. Goodman,et al.  A controlled trial of leuprolide with and without flutamide in prostatic carcinoma. , 1989, The New England journal of medicine.

[7]  M. Chen,et al.  Aberrant response in vitro of hormone‐responsive prostate cancer cells to antiandrogens , 1989, The Prostate.

[8]  F. Labrie,et al.  Low androgen levels induce the development of androgen-hypersensitive cell clones in Shionogi mouse mammary carcinoma cells in culture. , 1988, Journal of the National Cancer Institute.

[9]  L. Yam,et al.  Disseminated prostatic carcinoma simulating primary lung cancer. Indications for immunodiagnostic studies , 1988, Cancer.

[10]  M. Koutsilieris,et al.  Complete response of lung metastases caused by prostatic cancer after chronic administration of a gonadotropin‐releasing hormone analog, buserelin (HOE 766) , 1987, The Prostate.

[11]  C. Putman,et al.  Advanced prostatic carcinoma: pulmonary manifestations. , 1985, Radiology.

[12]  F. Labrie,et al.  Complete androgen blockade for the treatment of prostate cancer. , 1985, Important advances in oncology.

[13]  B. Bolton.  PULMONARY METASTASES FROM CARCINOMA OF THE PROSTATE: INCIDENCE AND CASE REPORT OF A LONG REMISSION. , 1965, The Journal of urology.

[14]  M. Elkin,et al.  Metastases from cancer of the prostate. Autopsy and roentgenological findings , 1954, Cancer.