The long term results of Prostate Cancer Prevention Trial (PCPT) shows that reduction in prostate cancer risk does not guarantee improved survival for participants in a landmark chemoprevention trial.
Ian M. Thompson Jr., MD, of the University of Texas Health Science Center at San Antonio, and his colleagues compiled data from 18 years of follow-up and showed that the usage of finasteride for more than seven years reduced the risk of prostate cancer but not necessarily affect mortality.
An overall survival of 78 percent has been found on men treated with placebo or finasteride. The initial outcome of the trial showed that finasteride was associated with a tiny but statistically notably rise in the risk of high-grade prostate cancer, but survival for 10 years are still the same with the treatment groups.
However, an 83 percent overall survival with finasteride and an 80 percent survival with placebo were found among men who developed low-risk prostate cancer.
The researchers concluded that the reduction in risk was entirely due to a relative reduction of 43 percent in the risk of low-grade cancer among men taking finasteride, as compared with placebo.
It has also been concluded that even though prevention of these tumors didn’t appear to lessen overall death cases, increased diagnosis of low-grade prostate cancer is a challenging side-effect of PSA testing and that the treatment adds little, if any benefit and in that all forms of therapy cause substantial burden to the patient.
Peter Scardino, MD, of Memorial Sloan-Kettering Cancer Center in New York City told Medpage that the most important message of the long-term results is that taking finasteride and other 5-alpha reductase inhibitors are completely safe and do not lead to a higher risk of death.
Scardino added that in terms of prostate cancer prevention, this research is really neutral; it does not tell us whether those drugs should or should not be taken.
This study can be read online in the New England Journal of Medicine.
