Effect of finasteride on serum androstenedione and risk of prostate cancer within the prostate cancer prevention trial: differential effect on high- and low-grade disease

Hoque, Ashraful, Yao, Song, Till, Cathee, Kristal, Alan R., Goodman, Phyllis J., Hsing, Ann W., Tangen, Catherine M., Platz, Elizabeth A., Stanczyk, Frank Z., Reichardt, Juergen K.V., vanBokhoven, Adrie, Neuhouser, Marian L., Santella, Regina M., Figg, William D., Price, Douglas K., Parnes, Howard L., Lippman, Scott M., Ambrosone, Christine B., and Thompson, Ian (2015) Effect of finasteride on serum androstenedione and risk of prostate cancer within the prostate cancer prevention trial: differential effect on high- and low-grade disease. Urology, 85 (3). pp. 616-620.

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Abstract

Objective: To evaluate the effect of finasteride on serum androst-4-ene-3,17-dione (androstenedione) and its association with prostate cancer risk among subjects who participated in the Prostate Cancer Prevention Trial.

Methods: We analyzed serum androstenedione levels in 317 prostate cancer cases and 353 controls, nested in the Prostate Cancer Prevention Trial, a randomized placebo-controlled trial that found finasteride decreased prostate cancer risk. Androstenedione is the second most important circulating androgen in men besides testosterone and also a substrate for 5α-reductase enzyme.

Results: We observed a 22% increase in androstenedione levels compared with the baseline values in subjects who were treated with finasteride for 3 years. This significant increase did not vary by case-control status. Adjusted odds ratio and 95% confidence interval for the third tertile of absolute change in androstenedione levels compared with the first tertile were 0.42 (95% confidence interval, 0.19-0.94) for low-grade (Gleason score <7) cases. Similar results were observed when analyzed using percent change. There were no significant associations between serum androstenedione levels and the risk of high-grade disease.

Conclusion: The results of this nested case-control study confirm that finasteride blocks the conversion of testosterone to dihydrotestosterone (DHT) and of androstenedione to 5α-androstanedione-3,17-dione, which also leads to the reduction of DHT formation. This decrease in DHT may help reduce the risk of low-grade prostate cancer in men. Our data on a differential effect of androstenedione also suggest that some high-grade prostate cancers may not require androgen for progression.

Item ID: 41831
Item Type: Article (Research - C1)
ISSN: 1527-9995
Funders: National Cancer Institute (NCI)
Projects and Grants: P01 CA108964, R03 CA117490 , CA37429
Date Deposited: 08 Dec 2015 18:24
FoR Codes: 06 BIOLOGICAL SCIENCES > 0601 Biochemistry and Cell Biology > 060103 Cell Development, Proliferation and Death @ 100%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920102 Cancer and Related Disorders @ 100%
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