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Civantos et al published the largest series on the pathology of androgen deprivation therapy for prostate cancer, and in the series of 173 patients who were treated with a luteinizing hormone-releasing hormone (LHRH) analogue and an antiandrogen (AA) prior to radical prostatectomy (RP), atrophy was observed in benign and malignant tissue.

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Thus, activation of these programs via inhibition of the axis provides a mechanism by which tumor cells can adapt to promote disease recurrence and progression.

The Panel did not include the other treatment options in the analysis and recommendations due to a combination of factors, including limited published experience and short-term follow-up as well as the similar issues that affected evaluations of other treatment options (see the "Methodology" and the "Summary of Treatment Complications" sections for an explanation of data limitations).

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RCT from Loma Linda and Massachusetts General Hospitals (Table 2) reported results for 392 patients with clinical stage T1 to T2 prostate cancer randomized to 70.

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There are already several medical treatments that act as androgen antagonists and have recognized uses; however, in recent years, there has been an increasing demand for complementary and alternative therapies, and this has included an interest in the development and use of more plant-derived anti-androgen therapies.

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It is for these reasons that it has largely replaced flutamide and nilutamide in clinical use.

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Second, the reduction in testosterone concentrations produced by medical or surgical castration decreases the potential competition between bicalutamide and testosterone for androgen receptors in prostate cells, allowing the use of a lower dose of antiandrogen in combined androgen blockade than is necessary in monotherapy.

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While the presence of a by-product represented by the following formula (A) (hereinafter sometimes referred to as by-product (A)) can be confirmed by LC, the by-product (A) may be converted to compound (2) at this time (see the following Scheme 2).

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In a multicenter, double-blind, controlled clinical trial, 813 patients with previously untreated advanced prostate cancer were to receive CASODEX (bicalutamide) 50 mg once daily (404 patients) or flutamide 250 mg (409 patients) three times a day, each in combination with LHRH analogs (either goserelin acetate implant or leuprolide acetate depot).

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Patients should be informed that therapy with bicalutamide and the LHRH analog should be started at the same time and that they should not interrupt or stop taking these medications without consulting their physician.

According to this method, compound (3) is oxidized with aqueous hydrogen peroxide as an oxidizing agent, in acetic acid or formic acid, for the synthesis of bicalutamide.

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