TY - JOUR
T1 - The utility of 5-α reductase inhibitors in the prevention and diagnosis of prostate cancer
AU - Reed, Amanda Beth
AU - Parekh, Dipen J.
PY - 2009/5/1
Y1 - 2009/5/1
N2 - PURPOSE OF REVIEW: We examine the role of 5-α reductase inhibitors in prevention and diagnosis of prostate cancer, highlight the basic science supporting this role, and analyze the phase III clinical trials addressing the association between 5-α reductase inhibitor use and prostate cancer. RECENT FINDINGS: To date, the Prostate Cancer Prevention trial (PCPT) is the only reported phase III randomized clinical trial to evaluate the role of 5-α reductase inhibitors in the prevention and treatment of prostate cancer. The original PCPT data revealed that finasteride reduced the risk of prostate cancer by approximately 25% in comparison with placebo. However, patients who received finasteride had a greater incidence of high-grade tumors, which prohibited acceptance of finasteride as a chemopreventive agent by most urologists. Recent updates of the PCPT findings confirmed that finasteride reduces the risk of clinically significant prostate cancer, including high-grade tumors, primarily due to its effects on improving the performance characteristics of prostate-specific antigen and prostate biopsy. There was no increase in high-grade prostate cancer. Rather, there was improved detection of high-grade prostate cancer due to decreased prostate volume. SUMMARY: Finasteride is a valuable chemopreventive tool because it reduces the risk of prostate cancer, including high-grade cancer, and enhances our ability to detect high-grade disease.
AB - PURPOSE OF REVIEW: We examine the role of 5-α reductase inhibitors in prevention and diagnosis of prostate cancer, highlight the basic science supporting this role, and analyze the phase III clinical trials addressing the association between 5-α reductase inhibitor use and prostate cancer. RECENT FINDINGS: To date, the Prostate Cancer Prevention trial (PCPT) is the only reported phase III randomized clinical trial to evaluate the role of 5-α reductase inhibitors in the prevention and treatment of prostate cancer. The original PCPT data revealed that finasteride reduced the risk of prostate cancer by approximately 25% in comparison with placebo. However, patients who received finasteride had a greater incidence of high-grade tumors, which prohibited acceptance of finasteride as a chemopreventive agent by most urologists. Recent updates of the PCPT findings confirmed that finasteride reduces the risk of clinically significant prostate cancer, including high-grade tumors, primarily due to its effects on improving the performance characteristics of prostate-specific antigen and prostate biopsy. There was no increase in high-grade prostate cancer. Rather, there was improved detection of high-grade prostate cancer due to decreased prostate volume. SUMMARY: Finasteride is a valuable chemopreventive tool because it reduces the risk of prostate cancer, including high-grade cancer, and enhances our ability to detect high-grade disease.
KW - 5-α reductase inhibitors
KW - Chemoprevention
KW - Finasteride
KW - Prostate cancer
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UR - http://www.scopus.com/inward/citedby.url?scp=67649710142&partnerID=8YFLogxK
U2 - 10.1097/MOU.0b013e328329eb29
DO - 10.1097/MOU.0b013e328329eb29
M3 - Review article
C2 - 19318950
AN - SCOPUS:67649710142
VL - 19
SP - 238
EP - 242
JO - Current Opinion in Urology
JF - Current Opinion in Urology
SN - 0963-0643
IS - 3
ER -