The 5-alpha-reductase inhibitor dutasteride Avodart appears to delay disease progression and the initiation of active treatment in men with low-risk, localized prostate cancer, results of a 3-year international clinical trial indicate.Treatment with dutasteride also reduces cancer-related anxiety, study authors found.”The results prove that using active surveillance plus dutasteride is a viable, safe, and effective treatment option for men who often undergo aggressive local treatment despite low risk of dying from the disease,” said first author Neil Fleshner, MD, of the University of Toronto’s Princess Margaret Hospital.
via 5-ARI delays prostate cancer progression in men with low-risk disease – – ModernMedicine.
This is the first study I’ve seen that shows that 5-alpha-reductase inhibitors may help slow the progression of prostate cancer. These medicines are tolerated well by most patients and treatment with avodart can be considered.
ORLANDO—Dutasteride, a drug widely prescribed for treating benign prostatic enlargement, lowers the risk of prostate cancer PCa progression in men undergoing active surveillance for the disease, researchers concluded.
via Dutasteride Slows Prostate Cancer Progression – Renal and Urology News.
Dutasteride has been used for BPH and is thought to help reduce the risk of developing prostate cancer. This study also supports its use for men on active surveillance. The medicine is mostly used for the treatment of benign enlargement of the prostate and can have sexual side effects in a small percentage of men.
“Although the REDUCE trial demonstrated a risk reduction in a large number of men, the committee chose to focus on a small number of high-grade cancers and determined that this class of drugs is inappropriate for prostate cancer risk reduction, even in the population of men with elevated PSA and previous negative biopsy,” added Dr. Gomella, a co-investigator of the REDUCE trial. “This decision will certainly reduce the enthusiasm for further large-scale, long-term studies of any prostate cancer chemoprevention or risk-reduction strategy.”
via FDA committee votes down 5-ARIs for prostate cancer risk reduction – – UrologyTimes.
This was a disappointing study for me. Medications such as avodart and proscar have been shown to reduce the risk of prostate cancer. Early studies revealing a higher percentage of high grade cancers have existed. These studies were based on biopsy specimens only, which often understage cancer.
Other studies that looked at patients who had removal of the prostate have not revealed a higher incidence of high grade cancers in patients on these medicines.
I will inform patients that the FDA did not approve the indication of prostate cancer reduction for avodart and proscar (finasteride). I think may patients will still opt for the medication. Patients with large prostates will also have the benefit of a reduction in BPH symptoms.