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Men treated with dutasteride have improved PSA prediction for high-grade tumors

Wednesday, January 12, 2011 (Last Updated: 01/13/2011)

WEDNESDAY, Jan. 12 (HealthDay News) -- Dutasteride enhances the efficacy of the prostate-specific antigen (PSA) test for diagnosing clinically significant prostate cancer, according to research published in the January issue of The Journal of Urology.

Gerald L. Andriole, M.D., of the Washington University School of Medicine in St. Louis, and colleagues examined results from the four-year REDUCE study, which evaluated the reduction of prostate cancer risk with the use of dutasteride. Men aged 50 to 75 years, with a PSA of 2.5 to 10.0 ng/mL and a negative prostate biopsy, were treated with 0.5 mg dutasteride or placebo daily.

The researchers found that the final PSA before biopsy and the change from month six to final PSA performed better for the diagnosis of Gleason score 7 to 10 tumors in the dutasteride group versus the placebo group. Increases in PSA were related to an increased likelihood of biopsy-detectable, Gleason score 7 to 10, and clinically significant prostate cancer. PSA percentage decreases from baseline to month six in the dutasteride group did not predict cancer overall or Gleason score 7 to 10 cancer.

"The REDUCE study demonstrates that dutasteride enhances the usefulness of PSA for diagnosing high Gleason grade prostate cancer and clinically relevant disease during four years. Although the initial decrease in PSA with dutasteride does not predict the diagnosis or grade of prostate cancer, a subsequent increase in PSA better identifies a population at increased risk for high-grade or clinically relevant tumors versus placebo," the authors write.

Andriole disclosed financial ties to pharmaceutical companies.

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