From the Guidelines
The pink tablet commonly given to people with prostate cancer is likely bicalutamide, which is often used as part of androgen deprivation therapy (ADT) to slow the growth of prostate cancer by blocking the effects of male hormones. According to the most recent and highest quality study 1, bicalutamide is still considered a viable option for some patients, given its different side-effect profile and lower cost compared to other treatments like enzalutamide. The study found that enzalutamide reduced the risk of progression or death by 76% compared with bicalutamide (HR, 0.24; 95% CI, 0.18–0.32) in patients with metastatic castration-resistant prostate cancer (mCRPC) 1. However, bicalutamide can still be considered in some patients, particularly those who have not yet undergone definitive primary therapy, as it may provide a reduction in the risk of disease progression, although it is unlikely to provide a survival benefit compared to delayed systemic treatment 1. Some key points to consider when prescribing bicalutamide include:
- The typical dose is 150 mg taken once daily
- It can be used as part of ADT to slow the growth of prostate cancer
- Patients should be monitored regularly for signs of disease progression and adverse events
- Bicalutamide can cause liver problems and other adverse events, so regular blood tests and monitoring are necessary
- The medication should be taken exactly as prescribed, and patients should be aware of the potential risks and benefits. It's also worth noting that enzalutamide has been shown to improve metastasis-free survival and overall survival in patients with non-metastatic CRPC, and is now considered a category 1, preferred treatment option for patients without prior novel hormone therapy in the mCRPC setting 1.
From the FDA Drug Label
Bicalutamide tablets are a prescription medicine called an androgen receptor inhibitor, used in combination with luteinizing hormone-releasing hormone (LHRH) medicines to treat Stage D2 metastatic prostate cancer.
The pink tablet given to people with prostate cancer is bicalutamide, an androgen receptor inhibitor used in combination with LHRH medicines to treat Stage D2 metastatic prostate cancer 2.
- Key points:
From the Research
Pink Tablet for Prostate Cancer
- The pink tablet referred to in the context of prostate cancer treatment is likely Bicalutamide, also known by its brand name Casodex 3, 4, 5, 6, 7.
- Bicalutamide is a nonsteroidal antiandrogen used in the treatment of prostate cancer, particularly for advanced cases 3, 4, 5.
- It can be administered as monotherapy or in combination with a luteinizing hormone-releasing hormone analogue (LHRH-A) 3, 4, 6, 7.
Efficacy and Tolerability
- Studies have shown that Bicalutamide, especially at a dose of 150 mg daily, offers equivalent survival outcomes to castration in patients with locally advanced prostate cancer 3, 5.
- When used in combination with an LHRH-A, a 50 mg daily dose of Bicalutamide has been found to be as effective as, or sometimes more effective than, other antiandrogens like flutamide, with better tolerability 4, 6.
- Bicalutamide is well-tolerated, with common side effects including breast pain and gynaecomastia, but it causes fewer instances of diarrhea compared to flutamide 4, 5, 6.
Dosage and Administration
- The dosage of Bicalutamide can vary, with 50 mg and 150 mg daily doses being commonly studied and used 3, 4, 5, 6.
- A study also investigated the use of Bicalutamide 80 mg combined with an LHRH-A in Japanese patients, showing benefits in time to treatment failure and disease progression 7.
- Bicalutamide's long elimination half-life allows for once-daily administration, making it a convenient option for patients 4, 5.