Androgen antagonists: Potential role in prostate cancer prevention

Area of Science:

• Oncology
• Urology
• Endocrinology

Background:

• Androgens play a crucial role in prostate cancer development.
• Estrogen antagonists prevent breast cancer, suggesting androgen blockade may prevent prostate cancer.
• 5alpha-reductase inhibitors block testosterone metabolism and inhibit prostate growth.

Purpose of the Study:

• To summarize discussions on androgens and androgen antagonists in prostate cancer genesis.
• To explore the potential of androgen-blocking agents for prostate cancer chemoprevention.
• To evaluate the role of 5alpha-reductase inhibitors and anti-androgens in prostate cancer prevention.

Main Methods:

• Review of symposium discussions on prostate cancer chemoprevention.
• Analysis of existing data on androgen antagonists and 5alpha-reductase inhibitors.
• Consideration of ongoing clinical trials, including a large finasteride prevention study.

Main Results:

• Limited data suggest 5alpha-reductase inhibitors reduce prostate-specific antigen levels.
• Finasteride, a 5alpha-reductase inhibitor, has a favorable toxicity profile for chemoprevention.
• Anti-androgens like bicalutamide are effective in prostate cancer treatment, but toxicity is a concern for prevention.

Conclusions:

• Androgen blockade is a potential strategy for prostate cancer prevention.
• Further investigation into predictive factors and novel agents is needed to reduce prostate cancer incidence.
• Balancing efficacy and toxicity is critical for developing preventive therapies.