Dutasteride and active surveillance of low-risk prostate cancer

摘要

We thank Chris Parker for his Comment (March 24, p 1O78)1 on our REDEEM trial.2 We agree that most men with very low-risk prostate cancer do not require radical treatment and that a longer study would have been ideal. Nevertheless, we disagree with his recommendation against the use of 5a-reductase inhibitors (5ARIs) in this setting.Many men with low-risk cancers receive treatment, especially in the USA where more than 90% receive radical or even hormonal therapy.3 Furthermore, many men on active surveillance discontinue expectant therapy owing to anxiety over worsening biopsy results or increasing prostate-specific antigen (PSA) concentrations. Parker is correct in that we did not correct PSA as in other studies. This point was carefully considered and deemed to limit our ability to assess real-world benefits of these drugs.