PCPT analysis shows finasteride lengthens lives by preventing Ca

If finasteride (Proscar) were prescribed prophylactically in older men, an estimated 316,760 years of life over 10 years would be saved through the prevention of prostate cancer, according to a new analysis of data from the Prostate Cancer Prevention Trial (PCPT).

The primary results of the PCPT, published in 2003, found the prevalence of prostate cancer decreased 24.8% with finasteride compared with placebo. But the study also found a potential increase in the rate of high-grade prostate cancers, leading to questions about the drug's safety as a preventive therapy.

In the new analysis, researchers used a statistical model and found that the benefits of finasteride would far outweigh the possible risks. The analysis, by the Southwest Oncology Group, was published in the Feb. 28 online version of the journal Cancer and will appear in the journal's print edition in April.

"We consider this to be a real breakthrough in analysis," said Charles A. Coltman, Jr, MD, chairman of SWOG and an author on the study. "Clearly finasteride would benefit older men by preventing prostate cancer."

Researchers added that an absolute increase of 6.9% of men with high-grade tumors in the U.S. cancer population would still mean 262,567 person-years saved.

"While we feel this analysis clearly shows the benefit of taking finasteride to prevent prostate cancer, we are continuing to study why some of the men who took finasteride while on the study developed high-grade cancers," said PCPT lead study coordinator Ian M. Thompson, MD, of The University of Texas Health Science Center, San Antonio. "We have already applied for funding to study this."