Current Oncology Reports

, Volume 10, Issue 6, pp 529–532

Prostate cancer chemoprevention: Update of the prostate cancer prevention trial findings and implications for clinical practice

Article

Abstract

This article updates the findings of the Prostate Cancer Prevention Trial (PCPT) based on recent publications and reviews of the PCPT. New evidence shows that finasteride reduces the overall risk of prostate cancer by 30% and reduces the risk of clinically significant prostate cancer, including high-grade tumors. For tumors with Gleason scores of ≤ 6, men in the finasteride arm had a relative risk reduction (RRR) of 34% (RR, 0.66; 95% CI, 0.55–0.80; P ≤ 0.0001); tumors with Gleason scores of ≥ 7 had an RRR of 27% (RR, 0.73; 95% CI, 0.56-0.96; P = 0.02). The effect of finasteride on sexual function appears to be minimal as men on finasteride had an average 3.21 point increase on the 100 point Sexual Activity Scale compared with men on placebo. With an excellent safety profile and minimal side effects, men aged 55 years or older should be informed of the opportunity to reduce their risk of prostate cancer with finasteride.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References and Recommended Reading

  1. 1.
    Thompson IM, Goodman PJ, Tangen CM, et al.: The influence of finasteride on the development of prostate cancer. N Engl J Med 2003, 349:215–224.PubMedCrossRefGoogle Scholar
  2. 2.
    Goodman PJ, Thompson IM, Tangen CM, et al.: The Prostate Cancer Prevention Trial: design, biases and interpretation of study results. J Urol 2006, 175:2234–2242.PubMedCrossRefGoogle Scholar
  3. 3.
    Lucia SM, Goodman PJ, La Rosa FG, et al.: Pathologic characteristics of cancers detected in the Prostate Cancer Prevention Trial: implications for prostate cancer detection and chemoprevention. Cancer Prevention Research 2008, May 18 (Epub ahead of press).Google Scholar
  4. 4.
    Epstein JI, Walsh PC, Carmichael M, Brendler CB: Pathologic and clinical findings to predict tumor extent of nonpalpable (stage T1c) prostate cancer. JAMA 1994, 271:368–374.PubMedCrossRefGoogle Scholar
  5. 5.
    Thompson IM, Ankerst DP, Chi C, et al.: Assessing prostate cancer risk: results from the Prostate Cancer Prevention Trial. J Natl Cancer Inst 2006, 98:529–534.PubMedGoogle Scholar
  6. 6.
    Thompson IM, Chi C, Ankerst DP, et al.: Effect of finasteride on the sensitivity of PSA for detecting prostate cancer. J Natl Cancer Inst 2006, 98:1128–1133.PubMedCrossRefGoogle Scholar
  7. 7.
    Thompson IM, Tangen CM, Goodman PJ, et al.: Finasteride improves the sensitivity of digital rectal examination for prostate cancer detection. J Urol 2007, 177:1749–1752.PubMedCrossRefGoogle Scholar
  8. 8.
    Redman MW, Goodman PJ, Lucia SM, et al.: Finasteride does not increase the risk of high-grade prostate cancer: a bias-adjusted modeling approach. Cancer Prevention Research 2008, May 18 (Epub ahead of press).Google Scholar
  9. 9.
    Moinpour CM, Darke AK, Donaldson GW, et al.: Longitudinal analysis of sexual function reported by men in the Prostate Cancer Prevention Trial. J Nat Cancer Instit 2007, 99:1025–1035.CrossRefGoogle Scholar
  10. 10.
    Andriole G, Bostwick D, Brawley O, et al.: Chemoprevention of prostate cancer in men at high risk: rationale and design of the reduction by dutasteride of prostate cancer events (REDUCE) trial. J Urol 2004, 172:1314–1317.PubMedCrossRefGoogle Scholar
  11. 11.
    Klein EA, Thompson IM, Lippman SM, et al.: SELECT: the next prostate cancer prevention trial. Selenium and Vitamin E Cancer Prevention Trial. J Urol 2001, 166:1311–1315.PubMedCrossRefGoogle Scholar
  12. 12.
    Lotan Y, Cadeddu JA, Lee JJ, et al.: Implications of the Prostate Cancer Prevention Trial: a decision analysis model of survival outcomes. J Clin Oncol 2005, 23:1911–1920.PubMedCrossRefGoogle Scholar
  13. 13.
    Unger JM. Estimated impact of the Prostate Cancer Prevention Trial on population mortality. Cancer 2005, 103:1375–1380.PubMedCrossRefGoogle Scholar
  14. 14.
    Svatek RS, Lee JJ, Claus GR, et al.: Cost-effectiveness of prostate cancer chemoprevention: a quality of life-years analysis. Cancer 2008, 112:1058–1065.PubMedCrossRefGoogle Scholar

Copyright information

© Current Medicine Group LLC 2008

Authors and Affiliations

  1. 1.Department of UrologyUniversity of Texas Health Science Center San AntonioSan AntonioUSA

Personalised recommendations