In a nutshell
The present study evaluated the efficacy of dutasteride (Avodart) in delaying PSA progression in patients who experienced recurrence after radical therapy for prostate cancer (PCa). PCa progression was significantly reduced in patients who received treatment with dutasteride.
Some background
Most patients with PCa receive treatment to remove or destroy the cancer. This is called radical therapy and usually consists of radical prostatectomy (complete removal of the prostate and some of the tissue around it) or radiotherapy. After treatment, PSA (a protein specific to the prostate) levels in the blood decrease. However, if the PSA levels begin to rise at any time after treatment it means that a recurrence (return of the cancer) may soon follow. Patients who experience rising PSA levels after radical therapy are at increased risk of cancer spreading to other organs of the body (metastasis). Dutasteride (Avodart) is a drug approved by the FDA for the treatment of an enlarged prostate gland (benign prostate hyperplasia). Dutasteride is also known to lower PSA levels in patients with PCa.
Methods & findings
This study included 294 patients with PCa. 147 of these patients received dutasteride and 147 received placebo (a substance that has no medical effect, used as a control in testing new drugs) daily for 2 years. All patients included in the study experienced PSA failure (a rise in PSA levels) after radical therapy for PCa. The main outcome investigated was the time to PSA doubling.
After 2 years of treatment, patients who received dutasteride had a 66% lower risk of PSA doubling compared to patients in the placebo group. Also, patients who were treated with dutasteride had a 59% lower risk of PCa progression compared to patients who received placebo. Both treatment groups experienced similar side effects, such as bladder control problems, breast growth, high blood pressure and back pain.
The bottom line
In conclusion, dutasteride treatment delayed cancer progression in patients with PSA failure following radical therapy for PCa.
The fine print
Potential drawbacks of this study are the small group of patients included and the relatively short follow up period after treatment. Larger trials are needed in order to confirm the effect of dutasteride on PCa progression. These studies could also determine if delayed cancer progression leads to longer overall survival in patients with PCa.
This study was funded by GlaxoSmithKline, the manufacturer of Avodart.
Published By :
European Urology
Date :
Nov 12, 2012
