The role of 5α-reductase inhibitors in the chemoprevention of prostate cancer

Sivkov A.V., Zhernov A.A., Keshishev N.G., Shkabko O.V.

Chemoprevention is the effect aimed at postponing the development of cancer or extension of time to progression. This can be achieved through the use of means slowing down the progression, causing inhibition or reversion of carcinogenesis processes to reduce the risk of developing invasive or clinically significant cancer.

The authors performed a review of data published on the results of clinical studies of chemoprevention.

One of the largest research studied the effect of of finasteride as a potential cancer chemopreventive agent, was a study conducted under the auspices of the U.S. National Institute of Cancer and named PCPT. Another large prospective, multicenter, randomized, placebo-controlled third phase trial dedicated to 5a-reductase inhibitor – Avodart was REDUCE study. The authors have set out the results and conclusions obtained in these and other studies of prostate cancer chemoprevention.

In addition, this article presents the results of authors’ own research on the effect of finasteride on prostate tissue in patients with BPH and PIN. The results of observation of 26 BPH patients, who received finasteride for six months and 10 patients with a similar disease under dynamic control. Thus, preliminary studies have shown: growth of epithelial atrophy, reduction in the incidence of metaplasia, reduction of accompanying inflammation and the potential use of finasteride in patients with BPH and PIN.

The authors demonstrated that finasteride is currently the only drug that reduces the frequency of development of prostate cancer, the effectiveness of which is confirmed in long-term prospective v clinical trials.

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