Alpha reductase inhibitors in the prevention of prostate cancer
Keywords:
Prostate cancer, 5-alpha reductase inhibitors, chemoprevention, pharmacogeneticsAbstract
Prostate cancer is one of the leading causes of male mortality worldwide. The 5-alpha reductase enzyme, via dihydrotestosterone, plays a central role in prostate tumor progression, which has driven the use of 5-alpha reductase inhibitors (5-ARIs) as a chemoprevention strategy. This article aims to analyze, from a qualitative perspective, the molecular mechanisms, clinical efficacy, and safety profile of 5α-reductase inhibitors (5-ARIs) in primary prevention. A comprehensive review of recent literature was conducted between 2020 and 2025, prioritizing original and systematically reviewed studies. The results describe that 5-ARIs modulate prostatic androgenic activity, promoting apoptosis and reducing cell proliferation, with a proven impact on reducing the incidence and progression of low- and intermediate-grade tumors, without increasing mortality or serious adverse events. Pharmacogenetics and individual factors influence the therapeutic response that supports the efficacy and safety of 5-ARIs, underscoring the importance of individualized selection based on clinical and genetic factors, and appropriate PSA monitoring. 5-ARIs constitute an effective and safe alternative for the primary prevention of prostate cancer, and personalized medicine strategies and continuous clinical surveillance are recommended.
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