The effects of the dual 5alpha-reductase inhibitor dutasteride on localized prostate cancer--results from a 4-month pre-radical prostatectomy study.
BACKGROUND
As dihydrotestosterone (DHT) is the most potent androgen in the prostate, inhibition of the 5alpha-reductase isoenzymes, which convert testosterone to DHT, could be an appropriate target for the treatment of prostate cancer.


METHODS
Eighty-one men with clinically localized prostate cancer received daily dutasteride 3.5 or 0.5 mg, or no therapy for 4 months before radical prostatectomy. Histopathological assessments were conducted on prostatectomy specimens.


RESULTS
Treatment with dutasteride was associated with reductions in serum and intraprostatic DHT of >or=90%, and a decrease in total prostate and tumor volumes. No effect of dutasteride was noted on Gleason grade. Histopathological effects on benign tissue were similar but less prominent than those seen with androgen ablation, whereas there was no significant difference in cancer histology among the groups.


CONCLUSIONS
Dutasteride treatment results in similar but less marked changes compared with androgen ablation.
Gleave
M
M
Prostate Centre at Vancouver General Hospital, Vancouver, British Columbia, Canada. gleave@interchange.ca
Qian
J
J
Andreou
C
C
Pommerville
P
P
Chin
J
J
Casey
R
R
Steinhoff
G
G
Fleshner
N
N
Bostwick
D
D
Thomas
L
L
Rittmaster
R
R
D058891:5-alpha Reductase Inhibitors; D000230:Adenocarcinoma / Q000097:blood / Q000188:drug therapy* / Q000473:pathology; D000368:Aged; D000369:Aged, 80 and over; D017209:Apoptosis / Q000187:drug effects; D001378:Azasteroids / Q000627:therapeutic use*; D049109:Cell Proliferation / Q000187:drug effects; D013196:Dihydrotestosterone / Q000097:blood; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D000068538:Dutasteride; D004791:Enzyme Inhibitors / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011467:Prostate / Q000187:drug effects / Q000378:metabolism / Q000473:pathology; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000473:pathology; D016896:Treatment Outcome
D058891:5-alpha Reductase Inhibitors; D001378:Azasteroids; D004791:Enzyme Inhibitors; D013196:Dihydrotestosterone; D000068538:Dutasteride