Statins Plus ADT May Up Survival in Advanced Prostate Cancer

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Statin use by men receiving ADT for advanced PCa was associated with decreased risk of overall and cancer-specific mortality.
Statin use by men receiving ADT for advanced PCa was associated with decreased risk of overall and cancer-specific mortality.

Statin use by men receiving androgen deprivation therapy (ADT) for prostate cancer (PCa) is associated with improved overall and cancer-specific survival, new data suggest.

The data are from an observational study that included 87,346 men on ADT for advanced PCa identified using the national Veterans Affairs database. Of these patients, 53,360 used statins and 33,986 did not. Statin users had a significantly longer median overall survival (6.5 vs 4.0 years) and a significantly greater 5-year cancer-specific survival rate (94% vs 87.3%), a team at the University of Wisconsin-Madison led by Kyle A. Richards, MD, reported online ahead of print in Urologic Oncology.

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Statin use independently predicted a significant 34% decreased risk of death from any cause, 44% decreased risk of death from PCa, and 36% decreased risk of skeletal-related events, after adjusting for multiple potential confounders, including age, race, Charlson comorbidity index (CCI), Gleason score, and PSA.

“Statins are inexpensive, well-tolerated medications that offer a promising adjunct to ADT, but require further prospective studies,” Dr Richards and his colleagues concluded.

The authors noted that statins are thought to have antineoplastic properties related to their effect on cell proliferation and steroidogenesis. Progression to castration-resistant PCa, they explained, includes de-regulation of androgen synthesis, suggesting a role for statins in this setting.

Statin users were significantly younger than nonusers (median 73 vs 76 years) and significantly more likely to have a CCI greater than 3 (3.1% vs 2.5%) and a Gleason score of 8–10 (12.3% vs 10.9%).

Reference

  1. Anderson-Carter I, Posielski N, Liou JI, et al. The impact of statins in combination with androgen deprivation therapy in patients with advanced prostate cancer: A large observational study. Urol Oncol. 2018; published online ahead of print.

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