Statin Use at the Time of Initiation of Androgen Deprivation Therapy and Time to Progression in Patients With Hormone-Sensitive Prostate Cancer. By Harshman et al. 2015
Key sentence from the paper: “Statin use at the time of ADT initiation was associated with a significantly longer [time to progression] during ADT even after adjustment for known prognostic factors.”
For the full abstract, see: http://oncology.jamanetwork.com/article.aspx?articleid=2288665
Commentary: Statins are drugs, like Lipitor and Crestor, used to lower cholesterol levels. But do they have any other benefits for patients starting on ADT? This article suggests that they do.
The authors did a retrospective look at a cohort of 926 patients, who had been on ADT. Of these, 644 (70%) of the patients experience disease progression in subsequent months. For patients, who were already on statin drugs, the median time to progression was 27.5 months. That compared to only 17.4 months for patients not on the cholesterol lowering medications.
The study also includes some bench science showing one of the ways in which statins may help control prostate cancer. One of the precursors in the production of testosterone from cholesterol is dehydroepiandrosterone sulphate (DHEAS). The statin drugs may interfere with the metabolic processing of DHEAS. These drugs may thus lower testosterone by reducing production of the precursor hormone.
There are now several prospective trials underway which will help us know who is most or least likely to benefit from adding ADT in terms of, not just disease progression, but overall survival and quality of life.
Harshman LC, Wang X, Nakabayashi M, Xie W, Valenca L, Werner L, Yu Y, Kantoff AM, Sweeney CJ, Mucci LA, Pomerantz M, Lee G-SM, Kantoff PW. 2015. Statin Use at the Time of Initiation of Androgen Deprivation Therapy and Time to Progression in Patients With Hormone-Sensitive Prostate Cancer. JAMA Oncol 7 May 2015 [Epub ahead of print].