Abstract
BackgroundActive surveillance (AS) has evolved as a management strategy for men with low grade prostate cancer (PCa). However, these patients report anxiety, doubts about the possible progression of the disease as well as higher decisional conflict regarding selection of active surveillance, and have been reported to ultimately opt for treatment without any major change in tumor characteristics. Currently, there is a paucity of research that systematically examines alternate strategies for this target population.MethodsWe conducted a review the evidence from epidemiological, in vitro, preclinical and early phase trials that have evaluated green tea catechins (GTC) for secondary chemoprevention of prostate cancer, focused on men opting for active surveillanceof low grade PCa.ResultsResults of our review of the in vitro, preclinical and phase I-II trials, demonstrates that green tea catechins (GTC) can modulate several relevant intermediate biological intermediate endpoint biomarkers implicated in prostate carcinogenesis as well as clinical progression of PCa, without major side effects.DiscussionAlthough clinical trials using GTC have been evaluated in early phase trials in men diagnosed with High-Grade Prostatic Intraepithelial Neoplasia, Atypical Small Acinar Proliferation and in men with localized disease before prostatectomy, the effect of GTC on biological and clinical biomarkers implicated in prostate cancer progression have not been evaluated in this patient population.ConclusionResults of these studies promise to provide a strategy for secondary chemoprevention, reduce morbidities due to overtreatment and improve quality of life in men diagnosed with low-grade PCa.
Highlights
Prostate cancer (PCa) remains, the most common non-cutaneous malignancy among men in the United States [1]
Results of our review of the in vitro, preclinical and phase I-II trials, demonstrates that green tea catechins (GTC) can modulate several relevant intermediate biological intermediate endpoint biomarkers implicated in prostate carcinogenesis as well as clinical progression of prostate cancer (PCa), without major side effects
Case-control and cohort studies addressing the relationship between GTC consumption and PCa risk have been mixed potentially attributed to varying formulations of catechins evaluated [22, 23]
Summary
Prostate cancer (PCa) remains, the most common non-cutaneous malignancy among men in the United States [1]. Active surveillance (AS) has evolved as a recommended management strategy for men with low risk disease, providing the benefit of an individualized approach of carefully monitoring disease progression using PSA kinetics, periodic biopsies and possibly surveillance MRI, sufficient to permit timely therapeutic intervention. Using this approach, in a large cohort of men on active surveillance followed over 15 years, Klotz et al, (2015) [7] demonstrated a 98% disease-specific survival for Gleason 3+3 tumors. There is a paucity of research that systematically examines alternate strategies for this target population
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