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| |  Finasteride Reduces Risk of Prostate Cancer Without Increasing Odds of Boosting Aggressive Cancers: Presented at AUA By Ric Susman ORLANDO, Fla -- May 23, 2008 -- Researchers say they believe that finasteride reduces the risk of prostate cancer -- and does so without increasing the odds that a patient might contract a more aggressive form of the disease. Their conclusion is based on a review of data from the landmark Prostate Cancer Prevention Trial (PCPT) presented here at the American Urological Association (AUA) Annual Meeting. "After their initial analysis of the 2003 trial, the Prostate Cancer Prevention Trial investigators discovered that men taking finasteride had fewer prostate cancers overall, but a higher incidence of high-grade cancers," noted Steven A. Kaplan, MD, Professor of Urology, Weill Cornell Medical College, and Urologist, New York-Presbyterian Hospital/Weill Cornell Medical Center, New York, New York. "It was important to find out if this finding was real, or some kind of methodological artefact," he added. Dr. Kaplan and his research team examined the records of more than 18,882 men aged more than 55 years who participated in the PCPT. In the trial, men taking finasteride had a 25% reduced risk of cancer; however, if cancer did occur in these patients, the disease was more aggressive than in the participants not taking the drug. "After their initial analysis, the PCPT investigators discovered that men taking finasteride had fewer prostate cancers overall, but a higher incidence of grades 7, 8, 9, and 10 cancers," Dr. Kaplan said in his late-breaker presentation on May 20. He noted that finasteride has long been used to treat benign prostatic hyperplasia. "So when we accounted for this shrinkage in prostate volume, the disparity in tumour aggressiveness between the finasteride and placebo groups vanished." "What we found was a significant reduction in the incidence of prostate cancers for men taking finasteride versus placebo -- even for the higher-grade cancers," Dr. Kaplan said. "Most importantly, finasteride was associated with significant declines in tumours with mid to high Gleason scores." He suggested that these findings suggest that men who are prescribed finasteride should not be concerned that the drug will boost their odds of developing aggressive prostate cancer. While it appears to be too early to say that the drug prevents the disease, it sometimes helps suppress cancer when cancer does occur, he said. "We know that finasteride shrinks the prostate. So perhaps that simply meant that doctors were better able to spot a highly aggressive tumour in patients taking the drug, because there was less tissue in which it could hide," said senior author E. Darracott Vaughan, MD, the James J. Colt Professor of Urology, Weill Cornell Medical College. With that in mind, the researchers looked once more at data on biopsies taken from the men in the PCPT study. They adjusted for treatment type, age, race, family history of prostate cancer, baseline prostate-specific antigen levels, and the individual patient's prostate volume. "What we found was a significant reduction in the incidence of prostate cancers for men taking finasteride versus placebo -- even for the higher-grade cancers," Dr. Kaplan said. "Most importantly, finasteride was associated with significant declines in tumours with Gleason scores 5, 6, and 7, which comprise 72% of all prostate cancers diagnosed in the United States. For tumours with Gleason scores of 8, 9, and 10, the incidence for men taking finasteride was no higher than for men not taking the drug, after we had adjusted for prostate volume." Funding for the PCPT trial was provided by the US National Cancer Institute and Merck & Co.
[Presentation title: New Findings From the PCPT: Evidence That Finasteride Significantly Reduced Prostate Cancer Risk Across Multiple Gleason Scores, Including the Most Frequently Detected Types of Clinically Significant Cancers (Gleason Scores 6 and 7).]
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