5-ARI delays prostate cancer progression in men with low-risk disease

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.

In the REDEEM (REduction by Dutasteride of clinical progression Events in Expectant Management of prostate cancer) trial, 302 men between the ages of 48 and 82 years diagnosed with low-risk localized prostate cancer were enrolled and placed under active surveillance. Participants were randomized 1:1 to receive dutasteride or a matching placebo daily. The men also underwent biopsies at 1.5 and 3 years.

By 3 years, 38% of men in the dutasteride group and 48% of controls had prostate cancer progression (p=.009).

Participants were also assessed for cancer-related anxiety, and the men on dutasteride reported feeling much less anxious because their biopsies and PSA values improved, Dr. Fleshner added.

Results from the study were published online in The Lancet (Jan. 24, 2012).

Funding for the study was provided by GlaxoSmithKline.

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