Statin use may lower prostate cancer risk recurrence in RT-treated patients
MedWire News: Research indicates that men undergoing radiation therapy (RT) for prostate cancer are more likely to remain relapse free, and less likely to experience biochemical disease recurrence, if they use statins before or during treatment.
However, the research team is unsure whether these improved outcomes are a direct result of the statin therapy itself, or a result of the lower low-density lipoprotein (LDL) levels induced by statins.
“There has been growing interest in the anticancer activity of statins based on preclinical evidence of their antiproliferative, pro-apoptotic, and radiosensitizing properties,” explain Stanley Liauw, from the University of Chicago in Illinois, USA, and team in the Journal of Clinical Oncology.
To investigate further, they evaluated freedom from biochemical failure (FFBF), as well as longer-term endpoints including freedom from salvage androgen deprivation therapy (FFSADT), and relapse-free survival (RFS) in a cohort of 691 men treated with RT for prostate cancer.
Among the group, 189 patients were taking statins either at the time of treatment initiation, or during the median 50-month follow-up.
Overall, the mean FFBF and RFS rates were 83% and 73% for the study cohort at 4 years after RT.
Statin users had significantly longer FFBF, RFS, and FFSADT than non-users. Furthermore, both univariate and multivariate analysis revealed statin use to be significantly associated with improved FFBF and RFS rates.
When patients were stratified according to high, intermediate, and low disease risk, statin use was still associated with improved FFBF rates compared with no statin treatment, at 85% versus 61%, 94% versus 84%, and 95% versus 91%, respectively.
The researchers observed an association between lower levels of lower total cholesterol and LDL before treatment, and improved FFBF rates. After 4 years, FFBF was 89% in men with pre-treatment total cholesterol levels below the median 187 mg/dl, and 95% in men with pre-treatment LDL levels below the median of 110 mg/dl, compared with a respective 80% and 85% in those with levels above the median.
Other variables associated with improved FFBF after multivariate analysis included a pre-treatment prostate-specific antigen level of 8.4 ng/ml or less, stage less than T2b, and a Gleason score below 7.
The researchers suggest that the anticancer effects of statins, as indicated by their results, “could allow for less use of androgen deprivation therapy as well as radiation dose de-escalation.”
They conclude: “These modifications could in turn lead to decreased treatment costs and decreased treatment morbidities.”
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By Sarah Guy