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Urology. 2008 May;71(5):947-51. doi: 10.1016/j.urology.2007.09.033. Epub 2008 Feb 15.

Etoricoxib and intermittent androgen deprivation therapy in patients with biochemical progression after radical prostatectomy.

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  • 1Department of Urology, University of Rome, Rome, Italy. sciarrajr@hormail.com

Abstract

OBJECTIVES:

To verify whether in patients with biochemical progression after radical prostatectomy (RRP), the administration of a cyclooxygenase-2 (COX-2) inhibitor during the off-phases of intermittent androgen deprivation (IAD) may increase the effectiveness and off-therapy time of intermittent therapy.

METHODS:

This is a comparative, prospective study. A total of 44 patients with biochemical progression after RRP were included in a clinical protocol for IAD once prostate-specific antigen (PSA) levels progressed over 0.4 ng/mL. The 44 cases were randomly assigned to receive two different treatment strategies: group A received IAD therapy using bicalutamide 150 mg once daily in the on-phases and no therapy in the off-phases; group B received IAD therapy using bicalutamide 150 mg once daily in the on-phases and etoricoxib 60 mg once daily in the off-phases.

RESULTS:

Median follow-up was 62 weeks. In group A 5 of 22 (22.7%) cases and in group B 2 of 22 (9.1%) cases failed to respond to IAD (P >0.05). Comparing the two groups, in all three cycles of IAD the time of the cycles and the time of the off-phases were significantly (P <0.0001) longer in group B than in group A. The highest PSA value reached during the off-phases in each cycle was significantly (P <0.001) lower in group B than in group A. Withdrawal from treatment owing to side effects was not necessary in any of the 44 patients.

CONCLUSIONS:

In patients with biochemical progression after RRP, we showed that the use of a COX-2 inhibitor in the off-phases of IAD is able to increase the off-treatment time significantly.

PMID:
18279940
[PubMed - indexed for MEDLINE]
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