Featured Research

from universities, journals, and other organizations

Data Re-analysis Shows Drug Finasteride May Reduce Risk For Most Prostate Cancers

Date:
May 24, 2008
Source:
New York- Presbyterian Hospital/Weill Cornell Medical Center/Weill Cornell Medical College
Summary:
A re-analysis of data from the landmark Prostate Cancer Prevention Trial finds that finasteride may reduce the risk for prostate cancer without boosting the odds of aggressive tumors. Adjusting for prostate volume, findings from landmark PCPT trial refute notion that drug boosts aggressive disease.

A re-analysis of data from the landmark Prostate Cancer Prevention Trial (PCPT) finds that finasteride reduces the risk for prostate cancer without boosting the odds of aggressive tumors.

Related Articles


PCPT, which involved more than 18,000 men 55 years of age or over, was stopped early in June 2003 because researchers noted that while it reduced prostate cancer in men taking finasteride (Proscar) by up to 25 percent, men taking finasteride also appeared to have more aggressive prostate tumors if and when they did develop the disease.

That caused some experts to worry that finasteride was encouraging higher-grade cancers.

But a new analysis led by researchers at NewYork-Presbyterian Hospital/Weill Cornell Medical Center should lay that worry to rest.

"Finasteride has long been used by doctors to treat benign enlarged prostate -- it shrinks the prostate. So when we accounted for this shrinkage in prostate volume, the disparity in tumor aggressiveness between the finasteride and placebo groups vanished," says study lead author Dr. Steven A. Kaplan, professor of urology at Weill Cornell Medical College and a urologist at NewYork-Presbyterian Hospital/Weill Cornell Medical Center.

He and his colleagues will present their findings May 20, at the annual meeting of the American Urological Association, in Orlando.

Physicians grade the aggressiveness of prostate tumors on what's called the Gleason Score -- a grading of tumor characteristics, with scores ranging from 2 to 10 (10 indicating the most highly aggressive cancers). "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 explains.

This was worrying, since it is higher-grade, potentially metastatic prostate cancers that are the real cause for clinical concern. "Lower-grade cancers are often what we call 'indolent,' meaning they grow so slowly they pose little real threat to the patient," Dr. Kaplan says. "So it was important to find out if this finding was real, or some kind of methodological artifact."

His team had one theory: "We know that finasteride shrinks the prostate. So perhaps that simply meant that doctors were better able to spot a highly aggressive tumor in patients taking the drug, because there was less tissue in which it could hide," explains senior author Dr. E. Darracott Vaughan, the James J. Colt Professor of Urology at Weill Cornell Medical College and a urologist at NewYork-Presbyterian Hospital/Weill Cornell Medical Center.

With that in mind, the researchers looked once more at PCPT data on biopsies taken from the 18,882 men in the study. They adjusted for treatment type, age, race, family history of prostate cancer, baseline prostate-specific antigen (PSA) 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 vs. placebo -- even for the higher-grade cancers," Dr. Kaplan says. "Most importantly, finasteride was associated with significant declines in tumors with Gleason scores 5, 6 and 7, which comprise 72 percent of all prostate cancers diagnosed in the United States. For tumors with Gleason scores of 8, 9 and 10, the incidence for men taking finastride was no higher than for men not taking the drug, after we had adjusted for prostate volume."

This means that men who are prescribed finasteride should not be concerned that the drug will boost their odds for aggressive prostate cancer. In fact, while it's too early to say that the drug prevents the disease, it may sometimes help suppress it when it occurs, the researchers say.

"I believe that the drug is chemo-suppressive," Dr. Kaplan says. "We know that it reduces PSA levels, which are indicative of prostatic disease. Finasteride appears to be particularly adept at suppressing the more indolent cancers. So in the future, it might be useful to use the drug to determine just how aggressive -- and needful of treatment -- a particular tumor is. If the patient takes finasteride and his PSA levels quickly drop, he probably has a less-threatening tumor that may just require 'watchful waiting.' But if PSA levels rise, that tumor may need more active treatment. All of this needs to be tested in a controlled, randomized trial."

In the meantime, researchers need to keep prostate volume in mind whenever they conduct trials assessing the anticancer properties of prostate-shrinking medications. "Right now, drug maker GlaxoSmithKline is testing out a similar drug, Avodart, as a possible agent against prostate cancer. We hope that they will incorporate prostate volume in their analysis, to help avoid the confusion that dogged PCPT," Dr. Kaplan says.

The PCPT trial was funded by the U.S. National Cancer Institute and Merck, the maker of finasteride.

Co-authors on this study include Dr. Claus Roehrborn, of the University of Texas Southwestern Medical School, Dallas; Dr. Alan G. Meehan, Dr. Bruce S. Binkowitz and Norman L. Heyden, of Merck Research Laboratories, Rahway, N.J.; and Dr. Kenneth S. Liu and Dr. Alexandra D. Carides, of Merck Research Laboratories in Upper Gwynedd, Penn.


Story Source:

The above story is based on materials provided by New York- Presbyterian Hospital/Weill Cornell Medical Center/Weill Cornell Medical College. Note: Materials may be edited for content and length.


Cite This Page:

New York- Presbyterian Hospital/Weill Cornell Medical Center/Weill Cornell Medical College. "Data Re-analysis Shows Drug Finasteride May Reduce Risk For Most Prostate Cancers." ScienceDaily. ScienceDaily, 24 May 2008. <www.sciencedaily.com/releases/2008/05/080520144001.htm>.
New York- Presbyterian Hospital/Weill Cornell Medical Center/Weill Cornell Medical College. (2008, May 24). Data Re-analysis Shows Drug Finasteride May Reduce Risk For Most Prostate Cancers. ScienceDaily. Retrieved November 27, 2014 from www.sciencedaily.com/releases/2008/05/080520144001.htm
New York- Presbyterian Hospital/Weill Cornell Medical Center/Weill Cornell Medical College. "Data Re-analysis Shows Drug Finasteride May Reduce Risk For Most Prostate Cancers." ScienceDaily. www.sciencedaily.com/releases/2008/05/080520144001.htm (accessed November 27, 2014).

Share This


More From ScienceDaily



More Health & Medicine News

Thursday, November 27, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Pet Dogs to Be Used in Anti-Ageing Trial

Pet Dogs to Be Used in Anti-Ageing Trial

Reuters - Innovations Video Online (Nov. 26, 2014) Researchers in the United States are preparing to discover whether a drug commonly used in human organ transplants can extend the lifespan and health quality of pet dogs. Video provided by Reuters
Powered by NewsLook.com
Today's Prostheses Are More Capable Than Ever

Today's Prostheses Are More Capable Than Ever

Newsy (Nov. 26, 2014) Advances in prosthetics are making replacement body parts stronger and more lifelike than they’ve ever been. Video provided by Newsy
Powered by NewsLook.com
From Popcorn To Vending Snacks: FDA Ups Calorie Count Rules

From Popcorn To Vending Snacks: FDA Ups Calorie Count Rules

Newsy (Nov. 25, 2014) The US FDA is announcing new calorie rules on Tuesday that will require everywhere from theaters to vending machines to include calorie counts. Video provided by Newsy
Powered by NewsLook.com
Daily Serving Of Yogurt Could Reduce Risk Of Type 2 Diabetes

Daily Serving Of Yogurt Could Reduce Risk Of Type 2 Diabetes

Newsy (Nov. 25, 2014) Need another reason to eat yogurt every day? Researchers now say it could reduce a person's risk of developing type 2 diabetes. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins