Oral Selenium Supplementation Has No Effect on Prostate-Specific Antigen Velocity in Men Undergoing Active Surveillance for Localized Prostate Cancer

Cancer Prevention Research
Q1
Jul 2010
Citations:56
Influential Citations:1
Interventional (Human) Studies
82
Low RoB
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Methods
Phase 2 randomized, double-blind, placebo-controlled multicenter clinical trial; men with biopsy-proven localized nonmetastatic prostate cancer who elected active surveillance; N=140; mean age 72.8 years; predominantly Caucasian; Gleason scores >4 in ~90%; baseline PSA ~7.9 ng/mL; baseline plasma selenium ~134 ng/mL; daily selenium from non-study sources limited to ≤50 μg.
Intervention
Selenized yeast (selenium); regimens of 200 μg/d and 800 μg/d; oral; up to 5 years.
Results
Selenium supplementation did not reduce PSA velocity vs placebo overall. PSA velocities for the 200 μg/d and 800 μg/d groups were not significantly different from placebo (P=0.32 and P=0.61). In the highest baseline selenium quartile, 800 μg/d selenium showed higher PSA velocity vs placebo (P=0.018). Selenium did not protect against progression as measured by PSA velocity; high-dose selenium may pose a risk for increased PSA velocity in men with high baseline selenium. Time to therapy did not differ between groups.
Limitations
Small sample size with dropout reducing power; baseline plasma selenium varied; PSA velocity as a surrogate progression marker may not fully reflect disease progression; no routine repeat biopsies during follow-up; multicenter design with potential center effects; possible underpowering to detect differences.

Abstract

The Nutritional Prevention of Cancer trial showed a 52% lower incidence of prostate cancer in men supplemented with selenium. As a result, our study was designed to assess whether selenium supplementation attenuates the progression of prostate cancer...