PTU - Polskie Towarzystwo Urologiczne
list of articles:

Chemoprevention of prostate cancer – new perspectives?
Article published in Urologia Polska 2008/61/3.


Zbigniew Jabłonowski
I Klinika Urologii Katedry Urologii Uniwersytetu Medycznego w Łodzi


prostate prostate cancer chemoprevention finasteride PCPT study


In Poland the amount of newly diagnosed prostate cancers increases systematically with the number of 7095 cases in 2005. It is
estimated that 200 000 men are diagnosed with prostate cancer in the USA annually and about 90% of them receive treatment for
it. The Prostate Cancer Prevention Trial (PCPT) was the first prospective, randomized, placebo-controlled clinical trial of prostate cancer
chemoprevention. Initial results of the study showed a greater proportion and number of histologically high-grade carcinomas. A new
analysis from the Prostate Cancer Prevention Trial shows that finasteride does not increase the risk for high-grade prostate cancer. The
latest data from 2008 demonstrate that chemopreventive treatment with finasteride for 7 years decreases the incidence of prostate
cancer by an estimated 30%, without increasing the incidence of high-grade tumours. The new analysis shows how small differences
in biopsy sensitivity between the study arms could results in the apparent finasteride-assosiated increase in high-grades on biopsy
that was reported in 2003. The findings of the PCPT seem to provide the foundation for the further studies on chemoprevention of
prostate cancer.


  1. Sporn MB: New agents for chemoprevention of prostate cancer. Eur Urol 1999, 35, 420-423.
  2. Leach R, Pollock B, Basler J et al: Chemoprevention of prostate cancer. Focus on key opportunities and clinical trials. Urol Clin North Am. 2003, 30 (2), 227-237.
  3. Paradigm Shift in the Primary Prevention of Prostate Cancer, Reanalysis of the PCPT Data. A Report from the 103rd Annual Meeting of the American Urological Association Orlando/May 17-22, 2008, Medical Frontiers International.
  4. Redman MW, Tangen CM, Goodman PJ et al: Finasteride does not increase the risk of high-grade prostate cancer, a bias-adjusted modeling approach. Cancer Prev Res 2008, Online First 2008, 10.1158/1940-6207. CAPR-08-0092.
  5. Raporty Centrum Onkologii, http//
  6. Dobruch J, Borówka A, Antoniewicz AA, Chłosta P: Prostatektomia radykalna w Polsce. Urol Pol 2005, 58, 2, 108-111.
  7. Brawley OW, Barnes ST: Potential agents for prostate cancer chemoprevention. Epidemiol Rev 2001, 23, 1, 168-172.
  8. Wang J, Eltoum IE, Lamartiniere CA: Genistein chemoprevention of prostate cancer in TRAMP mice. J Carcinog 2007, 16, 6, 3.
  9. Bonovas S, Filioussi K, Sitaras NM: Statin use and the risk of prostate cancer, a metaanalysis of 6 randomized clinical trials and 13 observational studies. Int J Cancer 2008, 15, 123, 899-904.
  10. Tindall DJ, Rittmaster RS: The rationale for inhibiting 5 alpha-reductase isoenzymes in the prevention and treatment of prostate cancer. J Urol 2008, 179, 4, 1235-1242.
  11. Festuccia C, Gravina GL, Muzi P et al: Effects of dutasteride on prostate carcinoma primary cultures, a comparative study with finasteride and MK386. J Urol 2008, 180, 1, 367-372.
  12. McCrohan MA, Morrissey C, O’Keane C, et al: Effects of the dual 5 alpha-reductase inhibitor dutasteride on apoptosis in primary cultures of prostate cancer epithelial cells and cell lines. Cancer 2006, 106, 12, 2743-2752.
  13. Gomella LG: Chemoprevention using dutasteride, the REDUCE trial. Curr Opin Urol 2005, 15, 1, 29-32.
  14. Musquera M, Fleshner NE, Finelli A, Zlotta AR: The REDUCE trial, chemoprevention in prostate cancer using a dual 5alpha-reductase inhibitor, dutasteride. Expert Rev Anticancer Ther 2008, 8, 7, 1073-1079.
  15. Thompson IM, Goodman PJ, Tangen CM et al: The influence of finasteride on the development of prostate cancer. N Engl J Med 2003, 349, 215-224.
  16. Scardino PT: The prevention of prostate cancer-the dilemma continues. N Engl J Med 2003, 349, 297-299.
  17. Lucia MS, Darke AK, Goodman PJ et al: Pathologic characteristics of cancers detected in the prostate cancer prevention trial, implications for prostate cancer detection and chemoprevention. Cancer Prev Res 2008, Online First 2008, 10.1158/1940-6207.CAPR-08-0078.
  18. Logothetis CJ, Schellhammer PF: High-grade prostate cancer and the Prostate Cancer Prevention Trial. Cancer Prev Res 2008, Online First 2008, 10.1158/1940-6207.CAPR-08-0085.
  19. D’Amico AV, Barry MJ: Prostate cancer prevention and finasteride. J Urol 2006, 176, 5, 2010-2013.
  20. 12. Lucia MS, Epstein JL, Goodman PJ et al: Finasteride and high-grade prostate cancer in the Prostate Cancer Prevention Trial. J Natl Cancer Inst 2007, 99, 1375-1383.
  21. Walsh PC: Implications of the prostate cancer prevention trial, a decision analysis model of survival outcomes. J Urol 2005, 174, 1293-1294.


Zbigniew Jabłonowski
I Klinika Urologii UM
ul. Żeromskiego 113
90-549 Łódź
tel. (042) 636 82 14