Atypical onset of bicalutamide-induced liver injury

World J Gastroenterol. 2016 Apr 21;22(15):4062-5. doi: 10.3748/wjg.v22.i15.4062.

Abstract

Anti-androgen therapy is the leading treatment for advanced prostate cancer and is commonly used for neoadjuvant or adjuvant treatment. Bicalutamide is a non-steroidal anti-androgen, used during the initiation of androgen deprivation therapy along with a luteinizing hormone-releasing hormone agonist to reduce the symptoms of tumor-related flares in patients with advanced prostate cancer. As side effects, bicalutamide can cause fatigue, gynecomastia, and decreased libido through competitive androgen receptor blockade. Additionally, although not as common, drug-induced liver injury has also been reported. Herein, we report a case of hepatotoxicity secondary to bicalutamide use. Typically, bicalutamide-induced hepatotoxicity develops after a few days; however, in this case, hepatic injury occurred 5 mo after treatment initiation. Based on this rare case of delayed liver injury, we recommend careful monitoring of liver function throughout bicalutamide treatment for prostate cancer.

Keywords: Bicalutamide; Drug-induced liver injury; Prostate neoplasm.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Androgen Antagonists / adverse effects*
  • Anilides / adverse effects*
  • Antineoplastic Agents, Hormonal / adverse effects*
  • Biopsy
  • Chemical and Drug Induced Liver Injury / diagnosis
  • Chemical and Drug Induced Liver Injury / drug therapy
  • Chemical and Drug Induced Liver Injury / etiology*
  • Chemotherapy, Adjuvant
  • Humans
  • Male
  • Middle Aged
  • Neoadjuvant Therapy / adverse effects*
  • Nitriles / adverse effects*
  • Prostatectomy
  • Prostatic Neoplasms / drug therapy*
  • Prostatic Neoplasms / surgery
  • Time Factors
  • Tosyl Compounds / adverse effects*
  • Treatment Outcome

Substances

  • Androgen Antagonists
  • Anilides
  • Antineoplastic Agents, Hormonal
  • Nitriles
  • Tosyl Compounds
  • bicalutamide