Effect of Dutasteride on the Risk of Prostate Cancer

• Published in: The New England journal of medicine Vol. 362; no. 13; pp. 1192 - 1202
• Main Authors: Andriole, Gerald L, Bostwick, David G, Brawley, Otis W, Gomella, Leonard G, Marberger, Michael, Montorsi, Francesco, Pettaway, Curtis A, Tammela, Teuvo L, Teloken, Claudio, Tindall, Donald J, Somerville, Matthew C, Wilson, Timothy H, Fowler, Ivy L, Rittmaster, Roger S
• Format: Journal Article
• Language: English
• Published: Waltham, MA Massachusetts Medical Society 01.04.2010
• Subjects: 5-alpha Reductase Inhibitors; adverse effects; Age; Aged; Azasteroids; Azasteroids - adverse effects; Azasteroids - therapeutic use; Biological and medical sciences; Biopsy; blood; Cancer; Cancer and Oncology; Cancer och onkologi; chemically induced; Double-Blind Method; drug therapy; Dutasteride; Enzyme Inhibitors; Enzyme Inhibitors - adverse effects; Enzyme Inhibitors - therapeutic use; Erectile Dysfunction; Erectile Dysfunction - chemically induced; General aspects; genetics; Gynecology. Andrology. Obstetrics; Heart Failure; Heart Failure - chemically induced; Humans; Life Sciences; Male; Male genital diseases; Medical sciences; Medicin och hälsovetenskap; Men; Middle Aged; Nephrology. Urinary tract diseases; pathology; Patient safety; prevention & control; Prostate; Prostate - pathology; Prostate cancer; Prostate-Specific Antigen; Prostate-Specific Antigen - blood; Prostatic Hyperplasia; Prostatic Hyperplasia - drug therapy; Prostatic Hyperplasia - pathology; Prostatic Neoplasms; Prostatic Neoplasms - genetics; Prostatic Neoplasms - pathology; Prostatic Neoplasms - prevention & control; Protein Isoforms; Risk; Testosterone 5-alpha-Reductase; therapeutic use; Treatment Outcome; Tumors; Tumors of the urinary system; Urinary tract. Prostate gland; Urologi och njurmedicin; Urology and Nephrology; Urinary system disease; Prostate disease; Enzyme; Enzyme inhibitor; Antiandrogen; Risk; Antihormone; Malignant tumor; Azasteroid; Medicine; Risk factor; Dutasteride; Oxidoreductases; Male genital diseases; Prostate cancer; 3-Oxo-5α-steroid 4-dehydrogenase; Cancer
• ISSN: 0028-4793; 1533-4406; 1533-4406
• DOI: 10.1056/NEJMoa0908127

Dutasteride, an inhibitor of 5α-reductase in the prostate, was tested in a large, randomized trial to determine its ability to prevent prostate cancer. Over the 4 years of the trial, dutasteride, as compared with placebo, reduced the relative risk of biopsy-detected prostate cancer by 23%. The reduction was limited mainly to tumors with Gleason scores of 5 or 6; by year 4, there were 12 tumors with Gleason scores of 8 to 10 in the dutasteride group but only 1 in the placebo group. Dutasteride, an inhibitor of 5α-reductase in the prostate, reduced the relative risk of biopsy-detected prostate cancer by 23%; however, the reduction was limited mainly to tumors with Gleason scores of 5 or 6. The 5α-reductase inhibitors that are used to treat benign prostatic hyperplasia block the conversion of testosterone to dihydrotestosterone and may reduce the risk of prostate cancer. 1 The results of the Prostate Cancer Prevention Trial showed that finasteride, as compared with placebo, reduced the risk of prostate cancer by 25%, but among the tumors that were detected, there was a 27% increase in the number of those that had Gleason scores of 7 to 10. 2 (The Gleason score is the sum of the two most common histologic patterns or grades in a prostate tumor, each of which is graded on a . . .