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Prostate cancer

Could the use of 5α-reductase inhibitors during active surveillance reduce the risk of disease progression?

Nature Reviews Urology volume 8, page 117 (2011)Cite this article

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5α-reductase inhibitors (5-ARIs) such as finasteride and dutasteride prevent the conversion of testosterone to dihydrotestosterone, a promoter of both benign and malignant growth of prostate tissue. Studies have indicated that this antiandrogenic effect might make this class of drug useful for preventing the occurrence—and, potentially, the progression—of prostate cancer. As active surveillance is becoming an increasingly popular management strategy for men with low-risk prostate cancer, Finelli et al. performed a retrospective, single-center study to examine whether concurrent 5-ARI use delayed pathologic progression in patients managed with this approach.

Overall, 288 men met the inclusion criteria for the analysis (serum PSA level <10 ng/ml, clinical stage T1c–T2a, Gleason score <6, ≤3 positive cores and no cores with >50% cancer involvement at the time of initial diagnostic biopsy). Patients were not included if they had used 5-ARIs before the diagnosis of prostate cancer. A confirmatory biopsy was performed 12 months after the initial biopsy, and every 2–3 years thereafter. Active surveillance included PSA measurement every 3–6 months and digital rectal examination every 6 months. Of the 288 men included, 70 were started on a 5-ARI before the diagnostic biopsy. The median follow-up duration was 38.5 months.

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ORIGINAL RESEARCH PAPER

  1. Finelli, A. et al. Impact of 5α-reductase inhibitors on men followed by active surveillance for prostate cancer. Eur. Urol. doi:10.1016/j.eururo.2010.12.018

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  1. Nick Warde
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Warde, N. Could the use of 5α-reductase inhibitors during active surveillance reduce the risk of disease progression?. Nat Rev Urol 8, 117 (2011). https://doi.org/10.1038/nrurol.2011.2

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