New Dutch study 1] below.
The rationale behind the combination of Casodex & Avodart was articulated in a 2009 paper [2]:
"Bicalutamide blocks androgen action in men with prostate cancer but has low affinity for the androgen receptor compared to dihydrotestosterone (DHT). Dutasteride, a dual 5-reductase inhibitor (5ARI), blocks the conversion of testosterone to DHT, reduces tumor volume and improves PSA in prostate cancer. Bicalutamide should be a more effective antiandrogen if it competes against intraprostatic testosterone, rather than DHT, for the androgen receptor."
Casodex with Avodart was used in a 2006 study [3], where a 3-month treatment prior to brachytherapy led to a substantial reduction in volume:
"The prostate gland and transition zone volume reductions after a 3-month course of neoadjuvant bicalutamide and dutasteride are comparable to previous reports of volume reduction using a luteinizing hormone-releasing hormone agonist with or without an antiandrogen."
Similar to [3], a 2016 Canadian paper [4] reported that:
"Dutasteride and Bicalutamide is a regimen of non-inferior efficacy to LHRH agonist based regimens for prostate volume reduction prior to permanent implant prostate brachytherapy."
In a 2025 study [5], "comparing the addition of bicalutamide with or without dutasteride to GnRH analogue therapy in men with non-metastatic castrate-resistant prostate cancer":
"The estimated median {time to disease progression} was 425 days ... in the bicalutamide/placebo group and 623 days ... in the bicalutamide/dutasteride group."
However: "In men with non-metastatic CRPC, adding dutasteride to bicalutamide did not significantly prolong {time to disease progression}."
In the new study [1]: "Bicalutamide monotherapy versus combined bicalutamide plus dutasteride therapy for patients with locally advanced or metastatic carcinoma of the prostate".
"At 3 years follow-up, PSA progression was found in 52 patients [65.8 % ...] in the monotherapy group compared to 38 patients (53.5 % ...) in the combined therapy group ...
"At the time of analysis 37 men (46.8 % ...) in the monotherapy group had died versus 30 men (42.3 % ...) in the combined therapy group. Median survival time was 5.4 and 5.8 years, respectively"
"... despite a trend toward higher efficacy of the combined therapy, progression-free survival and overall survival was not significantly different between the groups."
-Patrick
[1] ncbi.nlm.nih.gov/pubmed/273...
[2] ncbi.nlm.nih.gov/pubmed/197...
[3] ncbi.nlm.nih.gov/pubmed/168...
Bicalutamide 50 to 150 mg
