PSA and risk for prostate cancer in men taking dutasteride
Posted Dec 19 2010 12:00am
According to further analysis of data from the REDUCE trial, “… men who are taking dutasteride can be confident that the drug does not weaken the ability of PSA to find cancer if it develops. Rather, the drug enhances the ability to find cancer if PSA levels are rising.”
It has been known for some time that increases in PSA level in men being treated for benign prostatic hyperplasia (BPH) with a 5α-reductase inhibitor like dutasteride tended to be highly indicative for prostate cancer risk. The current study basically confirms this knowledge, based on data from the 8,000+ patients enrolled in the REDUCE trial.
In this 4-year-long study, men with a PSA level of between 2.5 and 10.0 ng/ml and an initial prostate biopsy that was negative for prostate cancer were treated either with 0.5 mg dutasteride once daily or with a placebo. The recent re-analysis has shown that:
The final PSA level before final biopsy and the change from month 6 to final PSA level performed better for the diagnosis of Gleason score 7-10 tumors in men who received dutasteride vs placebo.
Increases in PSA level were associated with a higher likelihood of biopsy detectable, Gleason score 7-10 and clinically significant prostate cancer.
Percentage decreases in PSA level from baseline to month 6 in the dutasteride arm did not predict prostate cancer overall or Gleason score 7-10 cancer.
Andriole and his colleagues conclude that in men with a previously negative prostate biopsy, PSA performed better during the 4-year study as a marker of prostate cancer in men who received dutasteride as compared to men receiving placebo. However, the authors do not suggest that men take dutasteride just to get a more accurate readout of PSA levels attributable to cancer. Dutasteride is associated with a series of side effects, just like every other drug. Rarely, those side effects may be serious.