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SYSTEMATIC REVIEW article

Front. Pharmacol.
Sec. Pharmacology of Anti-Cancer Drugs
Volume 16 - 2025 | doi: 10.3389/fphar.2025.1471442

Impact of Finasteride on Modulating the Risk and Clinical Outcomes of Bladder Cancer: Insights from a Comprehensive Meta-Analysis

Provisionally accepted
Ailing Yu Ailing Yu 1*Zian Bai Zian Bai 2*Yijie Wang Yijie Wang 2*， Xiaochen Du ， Xiaochen Du 3*Mengxin Chen Mengxin Chen 4*Shuang Wen Shuang Wen 5*Honglong Wang Honglong Wang 5*Xiao-Ying Yuan Xiao-Ying Yuan 6Chunyu Yang Chunyu Yang 7*Shanshan Bai Shanshan Bai 8*Bo Fan Bo Fan 2*
  • 1 First Clinical College, Dalian Medical University, Dalian, 116011, Liaoning Province, China, Dalian, Liaoning Province, China
  • 2 Department of Urology, Second Affiliated Hospital of Dalian Medical University, Dalian, China
  • 3 College of Humanities and Social Sciences, Dalian Medical University, Dalian, 116011, Liaoning Province, China, Dalian, 116011, Liaoning Province, China
  • 4 Second Clinical College, Dalian Medical University, Dalian, 116011, Liaoning Province, China, Dalian, Liaoning Province, China
  • 5 Department of Pathology, Dalian Friendship Hospital, Dalian 116001, Liaoning Province, China, Dalian, Liaoning Province, China
  • 6 Department of Anatomy, College of Basic Medicine, Dalian Medical University, Dalian 116044, China, Dalian, Liaoning Province, China
  • 7 Bidding and procurement office，Second Affiliated Hospital of Dalian Medical University, Dalian, 116011, Liaoning Province, China, Dalian, China
  • 8 Department of Ultrasound, First Affiliated Hospital of Dalian Medical University, Dalian, 116000，Liaoning Province, China, Dalian, China

The final, formatted version of the article will be published soon.

    Purpose: Numerous prior analyses have highlighted a potential link between androgen suppression therapy (AST) and bladder cancer (BCa). However, there is a notable gap in research specifically examining the influence of finasteride on BCa risk and clinical outcomes. This study aimed to evaluate preventive and therapeutic value of finasteride for BCa patients. Methods: This meta-analysis adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Guidelines. The PubMed, Embase, Cochrane Library, and Web of Science databases were searched up to December 20, 2024, to identify studies that examined the intake of finasteride and its impact on the incidence and clinical prognosis of patients with BCa. Data was extracted for further analysis by two different reviewers who independently examined the titles and abstracts of the included articles. Subgroup analyses and leave-one-out sensitivity analyses, were applied to mitigate the potential confounding factors associated with heterogeneity. Results: Our investigation revealed that finasteride markedly decreased the likelihood of developing BCa (hazard ratio [HR]: 0.75, 95% confidence interval [CI]: 0.63-0.88). Subgroup analyses indicated that the preventive effect of finasteride in BCa incidence were generally consistent, regardless of study region, types of research. Furthermore, no notable disparities were observed in OS, CSS, or RFS between the finasteride group and the control group. Conclusion: Finasteride plays a protective role against the progression of BCa, nevertheless, its effects on prognostic outcomes, including OS, CSS, and RFS, remain inconclusive. Additional multi-center prospective studies with long-term follow-up are required to further validate prophylactic role of finasteride on bladder cancer.

    Keywords: 5-alpha Reductase Inhibitors, Bladder cancer, Incidence, subgroup analysis, Meta-analysis

    Received: 27 Jul 2024; Accepted: 10 Jan 2025.

    Copyright: © 2025 Yu, Bai, Wang, Du, Chen, Wen, Wang, Yuan, Yang, Bai and Fan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Ailing Yu, First Clinical College, Dalian Medical University, Dalian, 116011, Liaoning Province, China, Dalian, Liaoning Province, China
    Zian Bai, Department of Urology, Second Affiliated Hospital of Dalian Medical University, Dalian, China
    Yijie Wang, Department of Urology, Second Affiliated Hospital of Dalian Medical University, Dalian, China
    ， Xiaochen Du, College of Humanities and Social Sciences, Dalian Medical University, Dalian, 116011, Liaoning Province, China, Dalian, 116011, Liaoning Province, China
    Mengxin Chen, Second Clinical College, Dalian Medical University, Dalian, 116011, Liaoning Province, China, Dalian, Liaoning Province, China
    Shuang Wen, Department of Pathology, Dalian Friendship Hospital, Dalian 116001, Liaoning Province, China, Dalian, Liaoning Province, China
    Honglong Wang, Department of Pathology, Dalian Friendship Hospital, Dalian 116001, Liaoning Province, China, Dalian, Liaoning Province, China
    Chunyu Yang, Bidding and procurement office，Second Affiliated Hospital of Dalian Medical University, Dalian, 116011, Liaoning Province, China, Dalian, China
    Shanshan Bai, Department of Ultrasound, First Affiliated Hospital of Dalian Medical University, Dalian, 116000，Liaoning Province, China, Dalian, China
    Bo Fan, Department of Urology, Second Affiliated Hospital of Dalian Medical University, Dalian, China

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