Kumar Nagi B, Pow-Sang Julio, Egan Kathleen M, Spiess Philippe E, Dickinson Shohreh, Salup Raoul, Helal Mohamed, McLarty Jerry, Williams Christopher R, Schreiber Fred, Parnes Howard L, Sebti Said, Kazi Aslam, Kang Loveleen, Quinn Gwen, Smith Tiffany, Yue Binglin, Diaz Karen, Chornokur Ganna, Crocker Theresa, Schell Michael J
H. Lee Moffitt Cancer Center and Research Institute Cancer Epidemiology, Tampa, Florida.
Department of Urology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.
Cancer Prev Res (Phila). 2015 Oct;8(10):879-87. doi: 10.1158/1940-6207.CAPR-14-0324. Epub 2015 Apr 14.
Preclinical, epidemiologic, and prior clinical trial data suggest that green tea catechins (GTC) may reduce prostate cancer risk. We conducted a placebo-controlled, randomized clinical trial of Polyphenon E (PolyE), a proprietary mixture of GTCs, containing 400 mg (-)-epigallocatechin-3-gallate (EGCG) per day, in 97 men with high-grade prostatic intraepithelial neoplasia (HGPIN) and/or atypical small acinar proliferation (ASAP). The primary study endpoint was a comparison of the cumulative one-year prostate cancer rates on the two study arms. No differences in the number of prostate cancer cases were observed: 5 of 49 (PolyE) versus 9 of 48 (placebo), P = 0.25. A secondary endpoint comparing the cumulative rate of prostate cancer plus ASAP among men with HGPIN without ASAP at baseline, revealed a decrease in this composite endpoint: 3 of 26 (PolyE) versus 10 of 25 (placebo), P < 0.024. This finding was driven by a decrease in ASAP diagnoses on the Poly E (0/26) compared with the placebo arm (5/25). A decrease in serum prostate-specific antigen (PSA) was observed on the PolyE arm [-0.87 ng/mL; 95% confidence intervals (CI), -1.66 to -0.09]. Adverse events related to the study agent did not significantly differ between the two study groups. Daily intake of a standardized, decaffeinated catechin mixture containing 400 mg EGCG per day for 1 year accumulated in plasma and was well tolerated but did not reduce the likelihood of prostate cancer in men with baseline HGPIN or ASAP.
临床前、流行病学及既往临床试验数据表明,绿茶儿茶素(GTC)可能降低前列腺癌风险。我们开展了一项安慰剂对照的随机临床试验,研究对象为97名患有高级别前列腺上皮内瘤变(HGPIN)和/或非典型小腺泡增生(ASAP)的男性,给予其服用Polyphenon E(PolyE),这是一种GTC的专利混合物,每天含有400毫克(-)-表没食子儿茶素-3-没食子酸酯(EGCG)。主要研究终点是比较两个研究组的累积一年前列腺癌发病率。未观察到前列腺癌病例数有差异:49名服用PolyE者中有5例(PolyE组),48名服用安慰剂者中有9例(安慰剂组),P = 0.25。次要终点是比较基线时无ASAP的HGPIN男性中前列腺癌加ASAP的累积发病率,结果显示该复合终点有所下降:26名服用PolyE者中有3例(PolyE组),25名服用安慰剂者中有10例(安慰剂组),P < 0.024。这一发现是由于与安慰剂组(25名中有5例)相比,PolyE组ASAP诊断数减少(26名中0例)。在PolyE组观察到血清前列腺特异性抗原(PSA)下降[-0.87纳克/毫升;95%置信区间(CI),-1.66至-0.09]。两个研究组中与研究药物相关的不良事件无显著差异。每天摄入含400毫克EGCG的标准化脱咖啡因儿茶素混合物,持续1年,可在血浆中蓄积且耐受性良好,但并未降低基线时有HGPIN或ASAP的男性患前列腺癌的可能性。