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Getting Nerdy: The Buzz on Bicalutamide (August 2024)

Bicalutamide (brand name Casodex) is an androgen receptor antagonist. Androgen receptors are messengers in cells that react to either testosterone or dihydrotestoterone (DHT.) Once receptors are occupied, they “turn on” and tell the cell to make or do something. Bica takes up the space that testosterone or DHT would normally fit into, and stops the receptor from telling the cell to do anything. Bica does not stop the body from making testosterone, so blood levels may not change (or may increase!) It does lower the body’s ability to use available testosterone – that’s why levels may increase: testosterone and DHT present in the body don’t get used, so there may be more of them circulating…

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 Casodex (Bicalutamide) Monotherapy

Casodex has fewer side effects than Lupron because it blocks testosterone’s activity instead of completely eradicating testosterone from the blood as Lupron does. Men on Casodex tend to experience less fatigue and a more moderate loss of libido* compared to men on Lupron... Since Casodex is somewhat less potent than Lupron, it should only be substituted for Lupron when the cancer is of a low-grade nature or when the patient is unable to tolerate Lupron due to being elderly or frail. The advantage of Casodex monotherapy is that it allows men to benefit from TIP’s anticancer benefits but with fewer side effects and better quality of life. Also, Casodex doesn’t have ongoing lingering effects after treatment is stopped, as is the case with Lupron.

Articles of Interest

Bicalutamide (Casodex) in the treatment of prostate cancer

Medical/surgical castration has traditionally been the mainstay of hormonal therapy but is associated with side effects including loss of libido and impotence. Nonsteroidal antiandrogens such as bicalutamide (Casodex) offer an effective alternative to castration with potential quality-of-life benefits.

How effective is Casodex for prostate cancer?

Casodex (biclutamide) is an anti-androgen type of hormone therapy used to treat prostate cancer that has metastasized (spread to other parts of the body.) When Casodex is used in combination with a luteinizing hormone-releasing hormone (LHRH) analog (either leuprolide depot or goserelin implant) Casodex + LHRH analog are more effective than leuprolide on its own.

Updates on Overcoming Bicalutamide Resistance: A Glimpse into Resistance to a Novel Antiandrogen

The standard androgen deprivation therapy for advanced prostate cancer includes the use of bicalutamide, which is a well-known antagonist of androgen receptors. Despite numerous benefits of the drugs in prostate cancer treatment, there is always a risk of developing a resistant phenotype, which paves the way for a more aggressive and low-survival type of prostate cancer. Over the years, many studies have investigated the candidate mechanisms of such resistance and have managed to find possible therapeutic solutions.

Resources

Casodex (Bicalutamide)

Casodex has fewer side effects than Lupron because it blocks testosterone’s activity instead of completely eradicating testosterone from the blood as Lupron does. Men on Casodex tend to experience less fatigue and a more moderate loss of libido* compared to men on Lupron.