Adding Statins to ADT May Delay PCa Progression
Statin users had a significantly longer median time to prostate cancer progression on ADT than non-users (27.5 vs. 17.4 months).
ORLANDO, Fla.—Taking a statin during treatment with androgen deprivation therapy (ADT) might lengthen the time before a prostate cancer (PCa) becomes resistant, according to new research presented at the 2015 Genitourinary Cancers Symposium.
Investigators led by Lauren C. Harshman, MD of the Dana-Farber Cancer Institute, Harvard Medical School, Boston, analyzed data from 926 patients with hormone-sensitive PCa treated with ADT at the institution from 1996–2013. Nearly a third of the men were taking a statin at ADT initiation. Statin users had a significantly longer median time to progression on ADT than non-users (27.5 vs. 17.4 months).
“Multiple epidemiological studies have generally shown a positive correlation between statin use and improved prostate cancer outcomes, but the mechanism of how statins might control prostate cancer has not been clearly elucidated,” Dr. Harshman said.
Xiaodong Wang, PhD, Dr. Harshman's collaborator at Dana-Farber, has studied the potential role of SLCO2B1, a transporter of hormones and drugs (such as statins) into PCa cells. In vitro laboratory results demonstrated that statins inhibit the cellular uptake of the adrenal androgen dehydroepiandrosterone sulfate (DHEAS), a precursor to more potent androgens, into PCa cells. For example, atorvastatin competes with DHEAS for transport, and in turn slows PCa cell proliferation. Statins also lower cholesterol, possibly hampering androgen synthesis.
“While this work needs to be validated prospectively, it suggests that statins may impact prostate cancer by decreasing the tumor's available androgen pool, and could be a valuable adjunct to our current therapies for prostate cancer or potentially as preventive agents,” Dr. Harshman told Renal & Urology News.
More than 10 prospective trials are underway to further characterize the role of statins as anticancer therapies in PCa.