Clinical and Biochemical Outcomes of Hormonal Therapy among Elderly Patients with Prostate Cancer in Sulaimani City

Authors

  • Chra Salahalddin Ahmed Department of Clinical Pharmacy, College of Pharmacy, University of Sulaimani, Kurdistan Region, Iraq https://orcid.org/0009-0005-2137-3468
  • Tavga Ahmed Aziz Department of Pharmacology and Toxicology, College of Pharmacy, University of Sulaimani, Kurdistan Region, Iraq https://orcid.org/0000-0003-2742-6127
  • Havan Freidun Fuad Qaftan Department of Oncology, Hiwa Cancer Hospital, Sulaimani, Kurdistan Region, Iraq
  • Saad Abdulrahman Hussain Department of Pharmacology and Toxicology, Faculty of Pharmacy, Al-Rafidain University College, Baghdad, Iraq https://orcid.org/0000-0002-1909-417X

DOI:

https://doi.org/10.54133/ajms.v9i1.2212

Keywords:

Abiraterone, Bicalutamide, Enzalutamide, Prostate cancer, Prostate specific antigen,, PS score.

Abstract

Background: Androgens, such as testosterone and dihydrotestosterone (DHT), have a major impact on the progression of prostate cancer because they activate the androgen receptors (AR) of prostate cancer cells. This condition is one of the most common cancers in males worldwide. Objectives: To evaluate the clinical and biochemical outcomes with bicalutamide, enzalutamide, and abiraterone in patients with prostate cancer. Methods: This is a retrospective study that included patients with advanced prostate cancer who were divided into three groups: bicalutamide, enzalutamide, and abiraterone treated groups. Data were collected from patients’ files at baseline and 6 and 12 months after treatment for measuring prostate-specific antigen, liver function, renal function, and lipid profile. Results: A remarkable decline in prostate size, prostate-specific antigen (PSA), back pain, and urinary symptoms was seen in all the groups after 12 months of treatment. Bicalutamide and abiraterone significantly attenuated total serum bilirubin (TSB). Meanwhile, enzalutamide significantly reduced alkaline phosphatase (ALP) level. Abiraterone resulted in a significant reduction in serum creatinine levels. A significant elevation of performance status (PS) score was noticed in the Enzalutamide and Abiraterone groups. Conclusions: Bicalutamide, enzalutamide, and abiraterone improved the outcomes of prostate cancer. Bicalutamide was superior to enzalutamide and abiraterone in improving PS.

 

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References

Siegel RL, Miller KD, Jemal A. Cancer statistics, 2020. CA Cancer J Clin. 2020;70(1):7-30. doi: 10.3322/caac.21590. DOI: https://doi.org/10.3322/caac.21590

Holm M, Doveson S, Lindqvist O, Wennman-Larsen A, Fransson P. Quality of life in men with metastatic prostate cancer in their final years before death - a retrospective analysis of prospective data. BMC Palliat Care. 2018;17(1):126. doi: 10.1186/s12904-018-0381-6. DOI: https://doi.org/10.1186/s12904-018-0381-6

Desai K, McManus JM, Sharifi N. Hormonal therapy for prostate cancer. Endocr Rev. 2021;42(3):354-373. doi: 10.1210/endrev/bnab002. DOI: https://doi.org/10.1210/endrev/bnab002

Culig Z. Response to androgens and androgen receptor antagonists in the presence of cytokines in prostate cancer. Cancers (Basel). 2021;13(12):2944. doi: 10.3390/cancers13122944. DOI: https://doi.org/10.3390/cancers13122944

Huggins C, Hodges CV. Studies on prostatic cancer. I. The effect of castration, of estrogen and androgen injection on serum phosphatases in metastatic carcinoma of the prostate. CA Cancer J Clin. 1972;22(4):232-240. doi: 10.3322/canjclin.22.4.232. DOI: https://doi.org/10.3322/canjclin.22.4.232

Vaishampayan UN, Heilbrun LK, Monk P, Tejwani S, Sonpavde G, Hwang C, et al. Clinical efficacy of enzalutamide vs bicalutamide combined with androgen deprivation therapy in men with metastatic hormone-sensitive prostate cancer: A randomized clinical trial. JAMA Netw Open. 2021;4(1):e2034633. doi: 10.1001/jamanetworkopen.2020.34633. DOI: https://doi.org/10.1001/jamanetworkopen.2020.34633

Hussein AA, Shabir U, Mahmood AW, Harrington G, Khan M, Ahmad A, et al. The impact of NCCN-compliant multidisciplinary conference on the uptake of active surveillance among eligible patients with localized prostate cancer. Urol Oncol. 2023;41(12):483. doi: 10.1016/j.urolonc.2023.09.013. DOI: https://doi.org/10.1016/j.urolonc.2023.09.013

Rawla P. Epidemiology of prostate cancer. World J Oncol. 2019;10(2):63-89. doi: 10.14740/wjon1191. DOI: https://doi.org/10.14740/wjon1191

Stolzenbach LF, Deuker M, Collà-Ruvolo C, Nocera L, Tian Z, Maurer T, et al. Differences between rural and urban prostate cancer patients. World J Urol. 2021;39(7):2507-2514. doi: 10.1007/s00345-020-03483-7. DOI: https://doi.org/10.1007/s00345-020-03483-7

Tsujino T, Tokushige S, Komura K, Fukuokaya W, Adachi T, Hirasawa Y, et al. Real-world survival outcome comparing abiraterone acetate plus prednisone and enzalutamide for nonmetastatic castration-resistant prostate cancer. Cancer Med. 2023;12(19):19414-19422. doi: 10.1002/cam4.6536. DOI: https://doi.org/10.1002/cam4.6536

Turpin A, Girard E, Baillet C, Pasquier D, Olivier J, Villers A, et al. Imaging for metastasis in prostate cancer: A review of the literature. Front Oncol. 2020;10:55. doi: 10.3389/fonc.2020.00055. DOI: https://doi.org/10.3389/fonc.2020.00055

Bang WJ, Kim H, Oh CY, Jo JK, Cho JS, Shim M. Clinical significance of prostate volume and testosterone reduction on lower urinary tract symptoms in patients with prostate cancer undergoing androgen deprivation therapy. Sci Rep. 2022;12(1):18535. doi: 10.1038/s41598-022-21963-1. DOI: https://doi.org/10.1038/s41598-022-21963-1

Li PY, Lu YH, Chen CY. Comparative effectiveness of abiraterone and enzalutamide in patients with metastatic castration-resistant prostate cancer in Taiwan. Front Oncol. 2022;12:822375. doi: 10.3389/fonc.2022.822375. DOI: https://doi.org/10.3389/fonc.2022.822375

Student S, Hejmo T, Poterała-Hejmo A, Leśniak A, Bułdak R. Anti-androgen hormonal therapy for cancer and other diseases. Eur J Pharmacol. 2020;866:172783. doi: 10.1016/j.ejphar.2019.172783. DOI: https://doi.org/10.1016/j.ejphar.2019.172783

Simcock R, Wright J. Beyond performance status. Clin Oncol (R Coll Radiol). 2020;32(9):553-561. doi: 10.1016/j.clon.2020.06.016. DOI: https://doi.org/10.1016/j.clon.2020.06.016

Yamashiro JR, de Riese WTW. Any correlation between prostate volume and incidence of prostate cancer: A review of reported data for the last thirty years. Res Rep Urol. 2021;13:749-757. doi: 10.2147/RRU.S331506. DOI: https://doi.org/10.2147/RRU.S331506

Zhaoyang X, Quanfa Z. Efficacy of bicalutamide in the treatment of prostate cancer. Chinese J Primary Med Pharm. 2020;11:1290-1293.

Azad AA, Armstrong AJ, Alcaraz A, Szmulewitz RZ, Petrylak DP, Holzbeierlein J, et al. Efficacy of enzalutamide in subgroups of men with metastatic hormone-sensitive prostate cancer based on prior therapy, disease volume, and risk. Prostate Cancer Prostatic Dis. 2022;25(2):274-282. doi: 10.1038/s41391-021-00436-y. DOI: https://doi.org/10.1038/s41391-021-00436-y

Heinrich D, Bruland Ø, Guise TA, Suzuki H, Sartor O. Alkaline phosphatase in metastatic castration-resistant prostate cancer: reassessment of an older biomarker. Future Oncol. 2018;14(24):2543-2556. doi: 10.2217/fon-2018-0087. DOI: https://doi.org/10.2217/fon-2018-0087

Sakamoto S, Maimaiti M, Xu M, Kamada S, Yamada Y, Kitoh H, et al. Higher serum testosterone levels associated with favorable prognosis in enzalutamide- and abiraterone-treated castration-resistant prostate cancer. J Clin Med. 2019;8(4):489. doi: 10.3390/jcm8040489. DOI: https://doi.org/10.3390/jcm8040489

Machidori A, Shiota M, Kobayashi S, Matsumoto T, Monji K, Kashiwagi E, et al. Prognostic significance of complete blood count parameters in castration-resistant prostate cancer patients treated with androgen receptor pathway inhibitors. Urol Oncol. 2021;39(6):365.e1-365.e7. doi: 10.1016/j.urolonc.2020.09.036. DOI: https://doi.org/10.1016/j.urolonc.2020.09.036

Loubersac T, Nguile-Makao M, Pouliot F, Fradet V, Toren P. Neutrophil-to-lymphocyte ratio as a predictive marker of response to abiraterone acetate: A retrospective analysis of the COU302 study. Eur Urol Oncol. 2020;3(3):298-305. doi: 10.1016/j.euo.2019.01.009. DOI: https://doi.org/10.1016/j.euo.2019.01.009

Uchimoto T, Komura K, Fujiwara Y, Saito K, Tanda N, Matsunaga T, et al. Prognostic impact of C-reactive protein-albumin ratio for the lethality in castration-resistant prostate cancer. Med Oncol. 2019;37(1):9. doi: 10.1007/s12032-019-1332-7. DOI: https://doi.org/10.1007/s12032-019-1332-7

Hoogland AI, Jim HSL, Gonzalez BD, Small BJ, Gilvary D, Breen EC, et al. Systemic inflammation and symptomatology in patients with prostate cancer treated with androgen deprivation therapy: Preliminary findings. Cancer. 2021;127(9):1476-1482. doi: 10.1002/cncr.33397. DOI: https://doi.org/10.1002/cncr.33397

Uhm SJ, Malamakal J. Enzalutamide administration for a nonhemodialysis patient with stage 4 chronic kidney disease and nonmetastatic castration-resistant prostate cancer. J Hematol Oncol Pharm. 2020;10(5):285-288.

Mishra S, Spencer H, Kelly K. Modified monitoring of abiraterone acetate-induced hepatotoxicity in prostate cancer patients. J Oncol Pharm Practice. 2024;0(0). doi:10.1177/10781552241291515. DOI: https://doi.org/10.1177/10781552241291515

Shaffi SK, Ravender R, Kodavanti CKM, Wagner B, Soleimani M. Abiraterone-associated mineralocorticoid excess: A case report. Cureus. 2024;16(1):e51757. doi: 10.7759/cureus.51757. DOI: https://doi.org/10.7759/cureus.51757

Raftopulos NL, Washaya TC, Niederprüm A, Egert A, Hakeem-Sanni MF, Varney B, et al. Prostate cancer cell proliferation is influenced by LDL-cholesterol availability and cholesteryl ester turnover. Cancer Metab. 2022;10(1):1. doi: 10.1186/s40170-021-00278-1. DOI: https://doi.org/10.1186/s40170-021-00278-1

Abdulfattah AY, Tajuddin S, Akkari N, Elsayed OI, Graham-Hill S. A rare case of bicalutamide-induced severe congestive heart failure in a patient with advanced prostate cancer. Cureus. 2024;16(5):e60298. doi: 10.7759/cureus.60298. DOI: https://doi.org/10.7759/cureus.60298

Bretagne M, Lebrun-Vignes B, Pariente A, Shaffer CM, Malouf GG, Dureau P, et al. Heart failure and atrial tachyarrhythmia on abiraterone: A pharmacovigilance study. Arch Cardiovasc Dis. 2020;113(1):9-21. doi: 10.1016/j.acvd.2019.09.006. DOI: https://doi.org/10.1016/j.acvd.2019.09.006

Betsikos A, Paschou E, Geladari V, Magaliou S, Sabanis N. Abiraterone-induced secondary hypertension: Two wrongs don't make a right. Cureus. 2024;16(5):e60299. doi: 10.7759/cureus.60299. DOI: https://doi.org/10.7759/cureus.60299

Serrano Domingo JJ, Alonso Gordoa T, Lorca Álvaro J, Molina-Cerrillo J, Barquín García A, Martínez Sáez O, et al. The effect of medical and urologic disorders on the survival of patients with metastatic castration resistant prostate cancer treated with abiraterone or enzalutamide. Ther Adv Urol. 2021;13:17562872211043341. doi: 10.1177/17562872211043341. DOI: https://doi.org/10.1177/17562872211043341

Loriot Y, Miller K, Sternberg CN, Fizazi K, De Bono JS, Chowdhury S, et al. Effect of enzalutamide on health-related quality of life, pain, and skeletal-related events in asymptomatic and minimally symptomatic, chemotherapy-naive patients with metastatic castration-resistant prostate cancer (PREVAIL): results from a randomised, phase 3 trial. Lancet Oncol. 2015;16(5):509-521. doi: 10.1016/S1470-2045(15)70113-0. DOI: https://doi.org/10.1016/S1470-2045(15)70113-0

Schweizer MT, Antonarakis ES. Abiraterone acetate: a hat trick of clinical benefits. Lancet Oncol. 2012;13(12):1173-1174. doi: 10.1016/S1470-2045(12)70460-6. DOI: https://doi.org/10.1016/S1470-2045(12)70460-6

Turco F, Di Prima L, Pisano C, Poletto S, De Filippis M, Crespi V, et al. How to improve the quality of life of patients with prostate cancer treated with hormone therapy? Res Rep Urol. 2023;15:9-26. doi: 10.2147/RRU.S350793. DOI: https://doi.org/10.2147/RRU.S350793

Laccetti AL, Morris MJ, Kantoff PW. A clinical evaluation of enzalutamide in metastatic castration-sensitive prostate cancer: Guiding principles for treatment selection and perspectives on research. Onco Targets Ther. 2020;13:13247-13263. doi: 10.2147/OTT.S242921. DOI: https://doi.org/10.2147/OTT.S242921

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Published

2025-08-18

How to Cite

Ahmed, C. S., Aziz, T. A., Qaftan, H. F. F., & Hussain, S. A. (2025). Clinical and Biochemical Outcomes of Hormonal Therapy among Elderly Patients with Prostate Cancer in Sulaimani City. Al-Rafidain Journal of Medical Sciences ( ISSN 2789-3219 ), 9(1), 214–221. https://doi.org/10.54133/ajms.v9i1.2212

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