CAB – An appropriate therapy for metastatic disease

LHRH-A* monotherapy does not suppress adrenal androgens¹

• The majority of serum testosterone (approximately 90%–95%) is reduced by
  LHRH-As¹
• However, adrenal androgens are still present and may stimulate prostate cancer growth¹
  • Approximately 40% of DHT†, which is converted from adrenal androgens, is still present in the prostatic tissue and may stimulate prostate cancer growth¹

Antiandrogens block action of androgens at the cellular level^1,2

*Luteinizing hormone-releasing hormone analog
† Dihydrotestosterone

CAB is Combined Androgen Blockade

The dual action of CAB provides androgen deprivation beyond LHRH-A alone^2,3:

• Antiandrogens block the binding of androgens at the receptor level in prostatic tissue²
• LHRH-As inhibit the production of testicular androgens¹

CAB therapy is medical (eg, LHRH-A) or surgical castration used concomitantly with an antiandrogen^2,3

• Adding an antiandrogen after initiation of an LHRH-A has not been adequately studied⁴

CAB – An integral part of the treatment plan

Treatment Continuum for Prostate Cancer

*Does not include patients who have only a rising PSA

After failure of primary therapy:

• CAB should be initiated when patients present with advanced prostate cancer^5,6
• CAB is not the last treatment option⁸
• Other therapies are available after CAB when patients progress⁸

In the United States:

• 1 in 6 new cancer cases are prostate cancer⁹
• Approximately 30,000 men will die of prostate cancer each year⁹

In advanced prostate cancer, when considering hormonal therapy, choose CAB.

References:

1. Labrie F, Belanger A, Simard J, et al. Combination therapy for prostate cancer. Cancer. 1993;71(suppl):1059-1067.
   
   
2. Garnick MB. Prostate cancer: screening, diagnosis, and management. Ann Intern Med. 1993;118;804-818.
   
   
3. Loblaw DA, Mendelson DS, Talcott JA, et al. American Society of Clinical Oncology recommendations for the initial hormonal management of androgen-sensitive metastatic, recurrent, or progressive prostate cancer. J Clin Oncol. 2004;22:1-15.
   
   
4. Data on file. DA-CAS-04, AstraZeneca Pharmaceuticals LP, Wilmington, Delaware.
   
   
5. Prostate Cancer Trialists’ Collaborative Group. Maximum androgen blockade in advanced prostate cancer: an overview of the randomized trials. Lancet. 2000;355:1491-1498.
   
   
6. Klotz L. Combined androgen blockade in prostate cancer: meta-analyses and associated issues. BJU International. 2001;87:806-813.
   
   
7. Scher HI, Kolvenbag GJ. The antiandrogen withdrawal syndrome in relapsed prostate cancer. Eur Urol. 1997;31(suppl 2):3-7
   
   
8. Data on file. DA-CAS-05, AstraZeneca Pharmaceuticals LP, Wilmington, Delaware.
   
   
9. American Cancer Society. Cancer Facts & Figures 2005. Atlanta: American Cancer Society; 2005.
   
   

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