Statin use may lower PSA recurrence risk in high-risk prostate cancer patients
MedWire News: Men who use statins while bring treated with high-dose radiotherapy for high-risk prostate cancer have significantly better prostate-specific antigen (PSA) relapse-free survival (PRFS) rates than their counterparts who do not use statins, report researchers.
The association is significant even after adjustment for potential confounding factors, observes the US research team.
“These data suggest that statins have anticancer activity, and possibly provide radiosensitization when used in conjunction with radiotherapy in the treatment of prostate cancer,” write Michael Zelefsky from Memorial Sloan-Kettering Cancer Center in New York, and colleagues.
The team investigated the association between statin use and biochemical-free, metastases-free, and overall survival outcomes in a cohort of 1681 men with stage T1–T3 disease, 382 of whom were taking statins during their treatment course. All men underwent high-dose (median 81 Gy) radiotherapy.
PSA relapses (defined as any measurement 2 ng/ml above the nadir after treatment) occurred in 301 patients during the median follow-up time of 5.9 years.
The 5- and 8-year PRFS rates for men using statins were 89% and 80%, respectively, compared with rates of 83% and 74% for men who did not use statins.
Multivariate analysis, adjusted for potential confounders including age, T stage, Gleason score, National Comprehensive Cancer Network (NCCN) risk group, and radiation dose, showed that statin use reduced the risk for PSA relapse by 31%. A low T stage (T1 or T2), a Gleason score of 6 or less, and a pre-treatment PSA level below 10 ng/ml were also significant predictors for improved PRFS.
When stratified by NCCN risk groups, the researchers observed no significant differences in PRFS between patients and those who were not, among both low- and intermediate-risk patients.
However, high-risk patients who used statins had a statistically significant 48% reduction in risk for PRFS compared with high-risk non-statin users, with or without adjustment for confounding variables.
Conversely, statin use had no significant association with either distant metastasis-free survival or overall survival among the entire cohort, even when stratified by risk group.
“Given the biologic rationale and established safety of statins, additional studies are necessary to establish the optimal duration, dosage, and timing of statin medications,” conclude Zelefsky et al in the International Journal of Radiation Oncology Biology Physics.
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By Sarah Guy