Chemoprevention using dutasteride: the REDUCE trial

Purpose of review This article will review the design and rationale of the dutasteride prostate cancer chemoprevention trial known as the REDUCE trial ( Reduction by Dutasteride of Prostate Cancer Events) in the contest of the recently completed Prostate Cancer Prevention Trial. Recent Findings The Prostate Cancer Prevention Trial used the 5 alpha-reductase inhibitor finasteride to prevent prostate cancer in a prospective randomized trial. The trial demonstrated a nearly 25% reduction in the prevalence of prostate cancer compared with placebo. Finasteride is a type 2-specific 5 alpha-reductase inhibitor, whereas dutasteride is an inhibitor of both type 1 and type 2 5 alpha-reductase. Recent evidence suggests that there may be increased expression of the type 1 5 alpha-reductase ion prostate cancer versus benign prostate tissue making dutasteride an attractive agent to study. Summary Proof of principle has been demonstrated by the Prostate Cancer Prevention Trial that a chemoprevention strategy using a hormonal agent such as a 5 alpha-reductase inhibitor can be effective. The REDUCE trial will use the dual 5 alpha-reductase inhibitor dutasteride in a group of men identified at increased risk of developing prostate cancer to determine of this will be an effective chemoprevention strategy.