The role of 5-alpha-reductase inhibitors in active surveillance

Purpose of review Active surveillance is now considered one of the preferred treatments for men with favorable risk prostate cancer (PCa). Unfortunately, 30-50% of men choosing active surveillance will progress and require therapy. In this context, we will present recent data on the efficacy of 5-alpha-reductase inhibitors (5-ARIs) in secondary prevention among men with low-risk PCa choosing active surveillance. Recent findings Two recent studies including a multicenter randomized controlled study demonstrate that 5-ARI may reduce the rate of clinical progression in low-risk PCa. Summary 5-ARIs may play an important role in secondary prevention in low-risk PCa. These results should be interpreted with caution in view of the recent US Food and Drug Administration recommendation against PCa chemoprevention labeling for 5-ARIs.