aDivision of Urology, Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.
Curr Opin Urol. 2014 May;24(3):324-8. doi: 10.1097/MOU.0000000000000048.
Active surveillance is now one of the recommended treatment options for low-risk prostate cancer (PCa). However, about 10-30% of men on active surveillance will progress and require definitive therapy. In this review, we examine the role of 5-alpha reductase inhibitors (5-ARIs) in secondary prevention among men with low-risk PCa who opted to be managed by active surveillance.
Three retrospective studies and one randomized controlled trial have evaluated the role of 5-ARIs in preventing clinical progression among men followed by active surveillance. These studies largely support the role of 5-ARIs for secondary chemoprevention, although the drugs do not have an indication for this setting.
5-ARIs have been shown to play an important role in preventing clinical progression among men with low-risk PCa on active surveillance. However, in light of the US Food and Drug Administration recommendation against 5-ARIs for primary chemoprevention, these findings should be interpreted with caution. Patients should be made aware of this warning label before starting the drug.
主动监测目前是低危前列腺癌（PCa）的推荐治疗方法之一。然而，约 10-30%接受主动监测的男性会出现进展并需要明确的治疗。在本次综述中，我们检查了 5-α 还原酶抑制剂（5-ARIs）在选择主动监测的低危 PCa 男性中进行二级预防的作用。
三项回顾性研究和一项随机对照试验评估了 5-ARIs 在预防接受主动监测的男性临床进展中的作用。这些研究在很大程度上支持 5-ARIs 用于二级化学预防的作用，尽管这些药物在这种情况下没有适应证。
5-ARIs 已被证明在预防接受主动监测的低危 PCa 男性的临床进展中发挥重要作用。然而，鉴于美国食品和药物管理局反对将 5-ARIs 用于初级化学预防的建议，这些发现应谨慎解释。在开始使用药物之前，应让患者了解这一警告标签。
