Prostate cancer chemoprevention in men of African descent: current state of the art and opportunities for future research

Abstract

Prostate cancer is the most frequently diagnosed malignancy in men. However, African American / Black men are 60% more likely to be diagnosed with and 2.4 times more likely to die from prostate cancer, compared to Non-Hispanic White men. Despite the increased burden of this particular malignancy, no evidence-based recommendation regarding prostate cancer screening exists for the high risk population. Moreover, in addition to screening and detection, high-risk African American men may constitute a prime population for chemoprevention. Early detection and chemoprevention may thus represent an integral part of prostate cancer control in this population. Importantly, recent research have elucidated biological differences in the prostate tumors of African American compared to European American men,. The latter may enable a more favorable response in African American men to specific chemopreventive agents that target relevant signal transduction pathways. Based on this evolving evidence, the aims of this review are three-fold. First, we aim to summarize the biological differences that were reported in the prostate tumors of African American and European American men. Second, we will review the single and multi target chemopreventive agents placing specific emphasis on targeting the pathways implicated in prostate carcinogenesis. And lastly, we will discuss the most promising multi-target nutraceutical chemopreventive compounds. Our review underscores the promise of chemoprevention in prostate cancer control, as well as provides justification for further growth and investment in this filed to ultimately reduce prostate cancer morbidity and mortality in this high risk population of African American men.

A phase II randomized clinical trial using aglycone isoflavones to treat patients with localized prostate cancer in the pre-surgical period prior to radical prostatectomy

“…It is estimated that 29,570 AAM will be diagnosed with prostate cancer in 2019 and 5,350 will die of the disease. PCa has a long latency period, characterized by abnormal differentiation of cells and tissue [2] and propelled by genetic and epigenetic changes [2][3][4]. Although reports have demonstrated a significant variation in PCa morbidity and mortality rates in population studies, the incidence of pre neoplastic lesions [5,6] and PCa in autopsies [7] are comparable, implying the influence of other environmental factors in the etiology of this disease and the potential to prevent PCa utilizing pharmacological approaches [8][9][10] Large phase III trials evaluating strategies for PCa chemoprevention have included 5-alpha-reductase inhibitors, finasteride and dutasteride [11][12][13].…”