A recent study suggested that phenelzine, a monoamine oxidase inhibitor, shows therapeutic potential in patients with biochemical recurrent castrate-sensitive prostate cancer.
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There was a total of 20 patients with average age of 66.9
years old with biochemical recurrent prostate cancer defined by prostate-specific
antigen (PSA) >0.4 ng/ml or PSA >2 ng/ml above nadir (after
radiation therapy) received phenelzine 30 mg orally twice daily. All of the
male patients had normal androgen levels, and there was no evidence of metastasis
on imaging.
Findings showed maximal PSA reduction of >
30% in 5 patients and of >50% in two patients. Of the 17 patients who
remained on treatment at 12 weeks, four (24%) and 1 (6%) achieved PSA reduction
of >30% and >50%, correspondingly.
There were common toxicities recorded such as
dizziness, hypertension, and edema. One episode of grade 4 hypertension and 2
episodes of grade 3 syncope resulted in treatment discontinuation.
Regarding mood symptoms, hospital anxiety depression
scored (HADS) questionnaire responses revealed a significant decrease in
anxiety with no change in depressive symptoms on treatment.
The monoamine oxidase A (MAOA) has been verified to
influence prostate cancer growth and metastasis in preclinical models. Current
data shows that therapies directed at monoamine oxidase A may indeed represent
a new option for treating recurrent prostate cancer.
Source: Prostate Cancer Prostatic Dis 2021;24:61-68