Do statins help the treatment of patients with prostate cancer using androgen-deprivation therapy?

This study explored the outcomes of statin (cholesterol-lowering drugs) treatment in patients with prostate cancer (PCa) undergoing androgen deprivation therapy (ADT). The authors found that the combination of statins and ADT improved the outcomes of these patients and intermittent ADT (IADT) increased the time without treatment compared to continuous ADT (CADT).

PCa growth and spread are commonly fueled by male sex hormones (androgens) such as testosterone. ADT is a hormonal therapy that blocks the production of androgens. This stops PCa growth and spread. However, ADT is associated with cardiovascular side effects such as an increased risk of heart attacks or heart-related death.

Statins are usually prescribed to lower cholesterol levels in the blood. They help improve cardiovascular health and reduce the risk of major heart-related events such as heart attacks or strokes. Previous research showed that statin use improved the outcomes of patients with cancer. Statins may help to reduce the side effects of ADT. However, the outcomes of patients with PCa treated with ADT in combination with statins remain under investigation.

This study included 1386 men with PCa who underwent radiotherapy. All patients had increased levels of the prostate-specific antigen (PSA; a protein made by the prostate), indicating that prostate cancer was coming back. The patients were randomly assigned to receive either intermittent ADT (IADT) or continuous ADT (CADT). 

In the IADT, patients were treated for 8 months with luteinizing hormone-releasing hormone agonist (LHRHa) combined with a nonsteroidal antiandrogen (the latter continued for a minimum of 4 weeks). The CADT group had the same treatment as IADT but without treatment breaks, meaning that the “off treatment” interval was not present. Some patients were also taking statins and some were not. Patients were followed up for an average of 6.9 years.

In both groups, patients using statins were 36% more likely to survive compared to those not using statins. In the IADT group, statin use was associated with longer time without ADT than those not using statins.

This study suggested that the association of statins and ADT improved the survival of patients with PCa.

Satins were not administrated as part of the trial itself. The treatment of the patients was analyzed after 4 years from the beginning of the study. This might have led to a misclassification of patients that were using statins at the same time as being enrolled for the study. Also, there was no indication of statins dosage and types. This might have affected the results.