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Ian Mr. Thompson Jr.
Finasteride has been shown to prevent prostate cancer safely and effectively, despite previous findings suggesting that the drug increases the risk of high-grade disease, according to long-term data published in the US. The New England Medical Journal.
The latest findings point to a mortality of more than two decades in men participating in the prostate cancer prevention trial, which had previously shown that finasteride reduced the risk of prostate cancer from 24.8% compared to placebo.
However, test results also showed that the drug increased the number of high-grade prostate cancers, leading to a warning label from the FDA. Although additional data have shown that finasteride improves the detection of prostate cancer and high-grade prostate cancer by improving the performance of PSA, digital rectal examination and prostate biopsy. that could explain previous contradictory results – questions about the risk of the drug persisted.
Finasteride, a 5-alpha-reductase inhibitor, is also used to treat lower urinary tract disorders and male pattern baldness.
"The men most likely to benefit are those we see in the study – they are 55 or older and are currently undergoing a PSA test," Ian Mr. Thompson Jr., MD, Chair of the Genitourinary Cancer Committee of the SWOG Cancer Research Network and Chair of the CHRISTUS Santa Rosa Hospital Medical Center, HemOnc today. "The magnitude of the benefit may be greater in men at higher risk of prostate cancer, than it is a man with a family history or a of an African American man. … But what we discovered in the initial study is that all men – regardless of their family background, race, ethnicity, and so on.
The investigators randomly badigned 18,882 men – enrolled from 1993 to 1997 – to receive finasteride or placebo for 7 years.
At the median follow-up of 18.4 years, 42 men in the finasteride group and 56 men in the placebo group died of prostate cancer.
The risk of death from prostate cancer badociated with finasteride, 25% lower, was not statistically significant (HR = 0.75, 95% CI: 0.5 to 1.12).
However, Mr. Thompson said the results helped eliminate concerns about the risk of more aggressive cancers badociated with finasteride, which he described as an inexpensive and reliable drug for the prevention of prostate cancer .
He said that he was not aware of any clear process that would remove the drug's warning label.
"But it's not enough to change the warning. It is also stated on the label that this drug leads to an unequivocal reduction in the risk of cancer, "said Thompson HemOnc today. "It's really a big problem. … If we had known that at the time of publication of the study, I suspect that many men, if not most of them, [aged] 55 years or older would take this medicine. But as there was a stain on it, it's a bit like a sticky fact. The trick will be to help the community get rid of this thorny fact and return to this original discovery.
"It's the most common cancer in men," said Thompson. "If men at risk for prostate cancer take it, we could eliminate 40,000 to 50,000 prostate cancers [diagnoses] a year, and it's a huge deal in terms of costs and suffering. "- by John DeRosier
For more information:
Ian M. Thompson Jr., MD, can be reached at: [email protected].
Disclosures: NCI and NIH funded this study. Thompson does not report any relevant financial information. Please consult the study for the relevant financial information of all other authors.
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