Published online Apr 21, 2016. doi: 10.3748/wjg.v22.i15.4062
Peer-review started: October 16, 2015
First decision: November 5, 2015
Revised: November 30, 2015
Accepted: December 30, 2015
Article in press: December 30, 2015
Published online: April 21, 2016
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.
Core tip: This case report describes a 62-year-old man with prostate cancer who experienced delayed liver injury after bicalutamide therapy. In previous case reports on bicalutamide-induced liver injury, liver failure occurred shortly after bicalutamide therapy initiation. However, in this case, liver injury occurred 5 mo after bicalutamide treatment initiation. Therefore, our case emphasizes that liver function measurements should be monitored from baseline for at least the first 6 mo of therapy, and then periodically during the entire period of treatment with bicalutamide.