Inhibition Of Human Prostate Cancer Progression By Administration Of Green Tea Catechins: A 2 Years Later Follow-Up Date
13 Jun 2008
ORLANDO, FL (UroToday.com) – Prostate cancer is an ideal target for chemoprevention strategies that, at present, may be the best approach, according to a group of Italian researchers. They cite a growing body of evidence that compounds from green tea (catechins: the most common are EGCG, EGC, ECG and EC) might posses anti-tumor activity.
Recently they showed that a Green Tea Catechins extract (GTCs) was very effective at inhibiting cancer growth in vitro and in animal model, triggering apoptotic death in cancer cells probably through induction of the nuclear form of Clusterin. In 2006 they published the result of a clinical trial demonstrating that about 90% inhibition of CaP development was indeed achievable by oral administration of GTCs to humans for one year.
Although this was the first study showing that GTCs are safe and very effective for treating pre-malignant lesions, it is evident that this important result needs confirmation with a larger study. But another important issue is still open: understanding whether CaP onset was definitively prevented or simply delayed by treatment. The purpose of this study was to evaluate results the after 2 years.
In the 2006 study, a cohort of 60 human volunteers bearing HG-PIN, the main pre-malignant lesion of CaP, were given 600mg/die of GTCs (n = 30) or placebo (n = 30) for 1y. At the end of the study, only 1 tumor was diagnosed among the GTCs-treated men, while 9 cancers were found among the placebo-treated men, with no significant side or adverse effects recorded. To check whether CaP onset was definitely prevented or simply delayed by treatment, the researchers managed to convince about 50% of patients from both arms (all asymptomatic) to undergo another round of prostate mapping by needle biopsy 2ys after suspension of GTCs administration.
They detected 1 more cancer in the cohort previously belonging to the GTCs-arm, and 2 more in that once belonging to the placebo-arm. Thus, 3 years after the beginning of the study and 2 years after suspension of GTCs administration, final results were: 11cancers in untreated volunteers versus 2 in those given GTCs for 1 year.
This novel data further strengthen the researchers previous result, strongly suggesting that CaP development might be definitely inhibited in men bearing HG-PIN (High-Grade Prostatic Intraepithelial Neoplasia) by administration of 600mg/day of GTCs for just 1year.
Rev Urol. 2002 Summer; 4(3): 157–158.
PMCID: PMC1475983
Copyright © 2002 MedReviews, LLC
High-Grade Prostatic Intraepithelial Neoplasia on a Prostate Biopsy—What Does It Mean?
Alan W Partin, MD, PhD
Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD
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Predicting Cancer Following a Diagnosis of High-Grade Prostatic Intraepithelial Neoplasia on Needle Biopsy: Data on Men with More than One Follow-Up Biopsy
Investigators in the field of urology, oncology, and pathology have been attempting to unravel the mystery of early diagnosis, treatment, and monitoring of men with prostate cancer for several decades. Recently a great deal of attention has been focused on obtaining a better understanding, both pathologically as well as clinically, of the pre-malignant lesion of prostatic intraepithelial neoplasia. Although not diagnostic of prostate cancer on a needle biopsy, many morphologic, molecular, histopathological, epidemiological, and genetic studies have offered strong evidence that high-grade prostatic intraepithelial neoplasia (HGPIN) is in fact a precursor lesion to development of invasive prostatic adenocarcinoma. Early studies in the literature that first characterized this relationship suggested that histologic evidence of HGPIN on a prostate biopsy predicted a nearly 50% risk of finding prostate cancer on a subsequent prostate biopsy. Through the years, much larger, prospective, population-based studies have suggested that this likelihood is more in the range of 25% to 30%. Knowing that the likelihood of finding prostate cancer after a “negative prostate biopsy” ranges between 10% and 25% if a repeat biopsy were performed brings into question the need or clinical utility of recommending immediate repeat prostate biopsy when HGPIN is seen on initial prostate biopsy.
Kronz and associates from the Department of Pathology at the Johns Hopkins Hospital in Baltimore, Maryland have recently published their work investigating how various HGPIN-related factors other than clinical and pathological variables can be used for cancer prediction following an initial diagnosis of HGPIN on a needle biopsy. This important research, published in The American Journal of Surgical Pathology this year, should be required reading for all urologists performing and interpreting the results of prostate needle biopsies within their practice.
The authors conclude that HGPIN does in fact carry with it a clinically significant likelihood of finding cancer in a subsequent prostate biopsy (30% overall), and that with increasing number of cores with HGPIN the likelihood of finding prostate cancer increases (to as much as 75% when more than three cores are found to have this histologic abnormality). They also caution that if cancer is not found on the first two follow-up biopsies after the initial diagnosis of HGPIN, it is unlikely that cancer will be found with subsequent biopsies, and the patient should be followed appropriately with yearly exams and PSA testing.
Presented by Brausi Maurizio, MD, Bettuzzi Saverio, MD, Peracchia Giancarlo, MD, Rizzi Federica, MD, and Corti Arnaldo, MD, at the Annual Meeting of the American Urological Association (AUA) – May 17 – 22, 2008. Orange County Convention Center – Orlando, Florida, USA.
Reported by UroToday.com Contributing Editor Christopher P. Evans, MD, FACS
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