Phase III Prostate Cancer Chemoprevention Trials

  • Howard L. ParnesEmail author
  • Otis W. Brawley
  • Lori M. Minasian
  • Leslie G. Ford
Part of the Recent Results in Cancer Research book series (RECENTCANCER, volume 202)


Chemoprevention refers to the use of pharmacologic interventions to delay, prevent, or reverse carcinogenesis with the ultimate goal of reducing cancer incidence. Two large, population-based, phase 3 prostate cancer prevention trials reported that 5-alpha reductase inhibitors significantly reduce prostate cancer risk. However, this class of agents were also associated with increased detection of high-grade prostate cancer. Another large, phase 3 prostate cancer prevention clinical trial showed no benefit for long-term supplementation with the trace element Se, given in the form of selenomethionine, or vitamin E, either individually or in combination. Paradoxically, a significant increase in prostate cancer was observed among men randomized to receive vitamin E alone. A great deal of progress had been made in the field of prostate cancer prevention over the past decade. Future studies will focus on prevention of disease progression in men on Active Surveillance, immunotherapy, mechanistically based drug combinations, and novel biomarkers of risk and benefit.


Prostate Cancer Gleason Score Prostate Cancer Incidence Prostate Cancer Prevention Prostate Cancer Prevention Trial 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. Bartsch G, Rittmaster RS, Klocker H (2000) Dihydrotestosterone and the concept of 5alpha-reductase inhibition in human benign prostatic hyperplasia. Eur Urol 37:367–380PubMedCrossRefGoogle Scholar
  2. Clark LC, Combs GF Jr, Turnbull BW et al (1996) Effects of selenium supplementation for cancer prevention in patients with carcinoma of the skin. A randomized controlled trial. Nutritional prevention of cancer study group. JAMA 276:1957–1963PubMedCrossRefGoogle Scholar
  3. Cooperberg MR, Broering JM, Kantoff PW, Carroll PR (2007) Contemporary trends in low risk prostate cancer: risk assessment and treatment. J Urol 178:S14–S19PubMedCentralPubMedCrossRefGoogle Scholar
  4. Heinonen OP, Albanes D, Virtamo J et al (1998) Prostate cancer and supplementation with alpha-tocopherol and beta-carotene: incidence and mortality in a controlled trial. J Natl Cancer Inst 90:440–446PubMedCrossRefGoogle Scholar
  5. Klein EA, Thompson IM Jr, Tangen CM et al (2011) Vitamin E and the risk of prostate cancer: the selenium and vitamin E cancer prevention trial (SELECT). JAMA 306:1549–1556PubMedCrossRefGoogle Scholar
  6. Lippman SM, Goodman PJ, Klein EA et al (2005) Designing the selenium and vitamin E cancer prevention trial (SELECT). J Natl Cancer Inst 97:94–102PubMedCrossRefGoogle Scholar
  7. Lippman SM, Klein EA, Goodman PJ et al (2009) Effect of selenium and vitamin E on risk of prostate cancer and other cancers: the selenium and vitamin E cancer prevention trial (SELECT). JAMA 301:39–51PubMedCentralPubMedCrossRefGoogle Scholar
  8. Lucia MS, Epstein JI, Goodman PJ et al (2007) Finasteride and high-grade prostate cancer in the prostate cancer prevention trial. J Natl Cancer Inst 99:1375–1383PubMedCrossRefGoogle Scholar
  9. Thompson IM, Goodman PJ, Tangen CM et al (2003) The influence of finasteride on the development of prostate cancer. N Engl J Med 349:215–224PubMedCrossRefGoogle Scholar
  10. Thompson IM, Chi C, Ankerst DP et al (2006) Effect of finasteride on the sensitivity of PSA for detecting prostate cancer. J Natl Cancer Inst 98:1128–1133PubMedCrossRefGoogle Scholar
  11. Tindall DJ, Rittmaster RS (2008) The rationale for inhibiting 5alpha-reductase isoenzymes in the prevention and treatment of prostate cancer. J Urol 179:1235–1242PubMedCentralPubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Howard L. Parnes
    • 1
    Email author
  • Otis W. Brawley
    • 2
  • Lori M. Minasian
    • 1
  • Leslie G. Ford
    • 1
  1. 1.Division of Cancer PreventionNational Cancer Institute BethesdaUSA
  2. 2.American Cancer SocietyAtlantaUSA

Personalised recommendations