Recently, the New England Journal of Medicine published an article on finasteride and dustasteride, whose brand names are Propecia, Proscar, and Avodart. The article may be summarized as follows. An analysis of trials evaluating finasteride and dutasteride indicate that the reduction in prostate cancer risk with both finansteride and dutasteride was limited to tumors with a modified Gleason Score of 6 or lower. Therefore, the trade off inherent in using a 5 alpha reductase inhibitor for prostate cancer prevention is the acceptance of one additional high grade cancer in order to avoid three to four theoretically clinically pertinent lower grade cancers.
The supposition drawn by the advisory committee in December was that finasteride and dutasteride do not have a advantageous risk-benefit profile for the propositioned use of chemoprevention of prostate cancer in healthy men. The FDA agrees with this assessment.