Taking a statin while undergoing androgen deprivation therapy (ADT) for prostate cancer appears to pay off when it comes to delaying disease progression, according to researchers at the Dana-Farber Cancer Institute.
They analyzed data on 926 men with prostate cancer receiving ADT and found that time to progression (TTP) was significantly delayed if the men were taking a statin.
They report in JAMA Oncology that there was a median of 27.5 months before disease progression in statin users compared to 17.4 months for men who did not take statins.1
In this study, all men had received ADT for biochemical or metastatic recurrence or de novo metastatic prostate cancer and were treated between January 1996 and November 2013.
The researchers previously had found that statins may compete with uptake of androgens (dehydroepiandrosterone sulfate [DHEAS]) by the transporter SLCO2B1 and that this results in decreased prostate cancer cell growth in cell lines.
“Clinically, we thought this may translate into improved cancer outcomes. So, we then looked at our large database of over 900 prostate cancer patients and found that patients taking statins at the time of ADT initiation had a significant delay in time to progression on ADT compared to non-statin users of approximately 10 months even when we controlled for many known prognostic factors,” said the study’s first author Lauren Harshman, MD, who is a medical oncologist at the Lank Center for Genitourinary Oncology at Dana-Farber Cancer Institute in Boston, MA.
“Taken together, this work suggests that statins may impact prostate cancer by decreasing the tumor’s available androgen pool and could be a valuable adjunct to our current therapies for prostate cancer. But our findings require validation. They also highlight that we need to be cognizant that commonly used medications may interfere with anticancer therapies either positively or negatively.”
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The researchers hypothesize that the mechanism through which statins exert their activity in prostate cancer appears to be multifactorial.
Statins may have antiproliferative and proapoptotic effects. DHEAS is a precursor of testosterone and a substrate for SLCO2B1. Statins rely on SLCO2B1, which is an organic anionic transporter, to gain entry to cells. In the study, 283 (31%) were taking a statin at ADT initiation.
After a median follow-up of 5.8 years, 644 patients (70%) were found to have experienced disease progression while receiving ADT.