PD55-02 THE USE OF FIVE-ALPHA REDUCTASE INHIBITORS AND THEIR ASSOCIATION WITH RECLASSIFICATION AND PATHOLOGIC OUTCOMES IN THE CANARY PROSTATE ACTIVE SURVEILLANCE STUDY (PASS) (2017)

You have accessJournal of UrologyProstate Cancer: Localized: Active Surveillance III1 Apr 2017PD55-02 THE USE OF FIVE-ALPHA REDUCTASE INHIBITORS AND THEIR ASSOCIATION WITH RECLASSIFICATION AND PATHOLOGIC OUTCOMES IN THE CANARY PROSTATE ACTIVE SURVEILLANCE STUDY (PASS) James Kearns, Anna Faino, Lisa Newcomb, James Brooks, Peter Carroll, Atreya Dash, William Ellis, Michael Fabrizio, Martin Gleave, Todd Morgan, Peter Nelson, Ian Thompson, Andrew Wagner, Yingye Zheng, and Daniel Lin James KearnsJames Kearns More articles by this author , Anna FainoAnna Faino More articles by this author , Lisa NewcombLisa Newcomb More articles by this author , James BrooksJames Brooks More articles by this author , Peter CarrollPeter Carroll More articles by this author , Atreya DashAtreya Dash More articles by this author , William EllisWilliam Ellis More articles by this author , Michael FabrizioMichael Fabrizio More articles by this author , Martin GleaveMartin Gleave More articles by this author , Todd MorganTodd Morgan More articles by this author , Peter NelsonPeter Nelson More articles by this author , Ian ThompsonIan Thompson More articles by this author , Andrew WagnerAndrew Wagner More articles by this author , Yingye ZhengYingye Zheng More articles by this author , and Daniel LinDaniel Lin More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.2425AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The outcomes of patients who enroll in active surveillance (AS) programs for prostate cancer (PCa) while currently taking five-alpha reductase inhibitors (5-ARIs) have not been well defined. Previous studies suggest that the initiation of 5-ARIs after enrolling in AS decreases the rate of reclassification and/or treatment for PCa, but there is still an FDA black box warning about the risk of grade risk prostate cancer while on 5-ARI. The objective of this study was to evaluate the safety of remaining on a 5-ARI after initiating AS for PCa. METHODS All men were enrolled in PASS. Inclusion criteria were current or never 5-ARI user, Gleason 3+3 or 3+4 PCa at diagnosis, ≤ 34% core ratio at diagnosis and ≥ 1 surveillance biopsy. Reclassification was defined as an increase in Gleason score and/or ratio of biopsy cores positive for cancer to ≥ 34%. RESULTS 1045 men were included in this study, 938 who had never used a 5-ARI and 107 5-ARI users. 5-ARI users had larger prostate volume (51 cc vs 40 cc, p < 0.01), a higher rate of BPH (77% vs 29%, p < 0.01) and older age (65 vs 62 years, p < 0.01). All other clinical parameters, including serum PSA, were statistically similar. There was no significant difference in any reclassification (p = 0.12). The use of 5-ARI at diagnosis was significantly protective for reclassification in a proportional hazards model (HR 0.68, p = 0.03); this difference was not significant after accounting for serum PSA, BMI, prostate size and positive cores ratio at diagnosis (HR 0.78, p = 0.18) (Table). There was no significant effect on adjusted analysis when evaluating for disease upgrading. 171 patients underwent radical prostatectomy (RP), 158 never 5-ARI users and 13 5-ARI users. There were no statistically significant differences when evaluating for Gleason grade or adverse pathology. 5-ARI users had a longer median time to RP (3.6 vs 2.1 years, p = 0.045). CONCLUSIONS There is no association between 5-ARI use at diagnosis and reclassification on AS for men in the Canary PASS cohort. 5-ARI users have a longer median time to RP and do not have more severe PCa at RP. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e1051 Advertisement Copyright & Permissions© 2017MetricsAuthor Information James Kearns More articles by this author Anna Faino More articles by this author Lisa Newcomb More articles by this author James Brooks More articles by this author Peter Carroll More articles by this author Atreya Dash More articles by this author William Ellis More articles by this author Michael Fabrizio More articles by this author Martin Gleave More articles by this author Todd Morgan More articles by this author Peter Nelson More articles by this author Ian Thompson More articles by this author Andrew Wagner More articles by this author Yingye Zheng More articles by this author Daniel Lin More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...