Researchers Find That Statin Use May Improve Survival in Advanced Prostate Cancer

According to the finding of three studies presented at the Genitourinary Cancer Symposiom, statins may improve overall survival among men with metastatic castration-resistant prostate cancer (mCRPC) and improve cancer-specific survival among those with high-risk prostate cancer (PCa).

In a post-hoc analysis of data from the randomized clinical trials COU-AA-301 and COU-AA-302, in which men with mCRPC were treated with prednisone plus placebo or abiraterone, researchers found that statin users had significantly better overall survival than non-users.

The reference group for both studies included patients in the placebo arm who did not use statins. Among statin users in the COU-AA-301 study, patients treated with prednisone plus abiraterone had a significant 29% decreased risk of death compared with the reference group. The investigators observed no significant decrease in death risk among statin users in the placebo arm.

In the COU-AA-302 study, statin users in the abiraterone and placebo groups had a significant 28% and 19% decreased risk of death, respectively, compared with the reference group.

In a completely separate study, researchers examined the effect of statin use on outcomes among patients with mCRPC receiving abiraterone, an anti-androgen that inhibits CYP17A1. Their analysis included 301 patients. Of these, 84 (28%) were statin users. The median overall survival for statin users and non-users was 16.2 and 11.3 months, a borderline significant difference in adjusted analyses.

The study authors concluded: “Although limited by sample size, our data showed a trend that statins may mildly enhance the anti-tumor effects of [abiraterone] in CRPC patients.”

The findings suggest that depletion of de novo cholesterol production may further limit androgen synthesis in concert with CYP17A1 inhibition.

In a population-based study of 12,700 men with high-risk PCa identified using the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database, researchers found that post-diagnostic use of statins is associated with a 47% lower risk of PCa mortality compared with patients with no documented statin use. Among obese patients, statin use was associated with a 62% decreased risk of PCa mortality. The investigators observed a synergistic effect of statins and metformin among patients with metastatic disease.

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