[Use of 5-alpha-reductase inhibitors in the prevention of prostate cancer].
5-alpha-reductase inhibitors are now in widespread use for the treatment of benign prostatic hyperplasia (BHP) and these molecules have recently come under the spotlight in prostate cancer. Their peripheral "hormonal" action inducing reduced intraprostatic DHT synthesis seems to involve them in this hormone-dependant disorder. Finasteride evaluated in the treatment of BPH (PLESS study) was found to have a preventive effect on the incidence of cancer and this activity was assessed in a specific trial (PCPT study). Nevertheless, in the latter randomized study with a 7-year follow-up period, a reduction in the global incidence of the number of cases of cancers was associated with an increase in the number of high-grade cancers. A slight reduction in prostate cancer was also noted in the studies with dutasteride in BPH (ARIA3001, ARIA3002 and ARIB3003). An international multicenter study (REDUCE) is currently being conducted to confirm the preventive value of this molecule which has a more complete activity than finasteride with its inhibitory action on the two 5-alpha-reductase iso-enzymes, and may therefore have a clearer efficiency and rule out the risk of onset of high-grade cancer.
Schulman
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Service d'urologie, cliniques universitaires de Bruxelles, hôpital Erasme, route de Lennik 808, B 1070 Bruxelles, Belgique. Claude.Schulman@ulb.ac.be
D000368:Aged; D001378:Azasteroids / Q000627:therapeutic use*; D042944:Cholestenone 5 alpha-Reductase / Q000037:antagonists & inhibitors*; D002986:Clinical Trials as Topic; D000068538:Dutasteride; D018120:Finasteride / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000517:prevention & control*
D001378:Azasteroids; D018120:Finasteride; D042944:Cholestenone 5 alpha-Reductase; D000068538:Dutasteride