TY - JOUR
T1 - Targeting α-reductase for prostate cancer prevention and treatment
AU - Nacusi, Lucas P.
AU - Tindall, Donald J.
PY - 2011/7
Y1 - 2011/7
N2 - Testosterone is the most abundant circulating androgen, and can be converted to dihydrotestosterone (DHT), a more potent androgen, by the α-reductase enzymes in target tissues. Current treatments for prostate cancer consist of reducing androgen levels by chemical or surgical castration or pure antiandrogen therapy that directly targets the androgen receptor (AR). Although these therapies reduce tumor burden and AR activity, the cancer inevitably recurs within 18g-30 months. An approach targeting the androgeng-AR axis at different levels could, therefore, improve the efficacy of prostate cancer therapy. Inhibition of α-reductase is one such approach; however, the two largest trials to investigate the use of the α-reductase inhibitors (5ARIs) finasteride and dutasteride in patients with prostate cancer have shown that, although the incidence of cancer was reduced by 5ARI treatment, those cancers that were detected were more aggressive than in patients treated with placebo. Thus, the best practice for using these drugs to prevent and treat prostate cancer remains unclear.
AB - Testosterone is the most abundant circulating androgen, and can be converted to dihydrotestosterone (DHT), a more potent androgen, by the α-reductase enzymes in target tissues. Current treatments for prostate cancer consist of reducing androgen levels by chemical or surgical castration or pure antiandrogen therapy that directly targets the androgen receptor (AR). Although these therapies reduce tumor burden and AR activity, the cancer inevitably recurs within 18g-30 months. An approach targeting the androgeng-AR axis at different levels could, therefore, improve the efficacy of prostate cancer therapy. Inhibition of α-reductase is one such approach; however, the two largest trials to investigate the use of the α-reductase inhibitors (5ARIs) finasteride and dutasteride in patients with prostate cancer have shown that, although the incidence of cancer was reduced by 5ARI treatment, those cancers that were detected were more aggressive than in patients treated with placebo. Thus, the best practice for using these drugs to prevent and treat prostate cancer remains unclear.
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U2 - 10.1038/nrurol.2011.67
DO - 10.1038/nrurol.2011.67
M3 - Review article
C2 - 21629218
AN - SCOPUS:79960205353
SN - 1759-4812
VL - 8
SP - 378
EP - 384
JO - Nature Reviews Urology
JF - Nature Reviews Urology
IS - 7
ER -