The following article features coverage from the ASCO Genitourinary Cancers Symposium 2022. Click here to read more of MPR‘s conference coverage.

Statin use does not appear to affect overall survival in patients with metastatic castration-resistant prostate cancer (mCRPC), according to findings presented at the 2022 American Society of Clinical Oncology (ASCO) Genitourinary Cancers Symposium.

To investigate the association between statin use and survival benefit in mCRPC, researchers conducted a nationwide retrospective cohort study of the Veteran Affairs population. Patients were included in the analysis if they had received a statin medication for 1 year prior to initiating treatment with either abiraterone or enzalutamide for mCRPC.

“A Cox proportional hazards model was used to estimate adjusted hazards ratio (aHR) with 95% confidence interval (CI) of overall survival after controlling for known prognostic factors including age, Charlson-Romano Comorbidity Index, use of bone-modifying agents, Body-Mass Index, and prostate specific antigen levels,” the researchers explained.

The analysis included 4919 patients, of which 19.7% (n=969) had received a lipophilic statin (eg, atorvastatin, simvastatin, lovastatin, fluvastatin, cerivastatin, pitavastatin) and 9.2% (n=452) had received a hydrophilic statin (eg, rosuvastatin, pravastatin).

Findings showed that statin use was not associated with improved overall survival in mCRPC patients (aHR 0.93; 95% CI, 0.87-1.00). A similar outcome was observed when accounting for the solubility profile of the statin. Both lipophilic and hydrophilic statins were not associated with an overall survival benefit in these patients (aHR 0.98; [95% CI, 0.90-1.06] and aHR 0.90; [95% CI, 0.80-1.01], respectively).

“When analyzing statin lipophilicity, we saw a higher trend towards survival in the hydrophilic statin group compared to the lipophilic statin group, which contradicts the direct anticancer benefits of lipophilic statins, but neither group reached statistical significance,” the researchers added.

They concluded that additional research into how statins affect other outcomes, such as the incidence of cardiovascular events or the effect on antiandrogen treatment duration, would help in selecting the best treatment approaches for mCRPC patients.

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.

Reference

Yoon H, Luo S, Sanfilippo KM, et al. Statin type and survival of patients with metastatic castrate-resistant prostate cancer receiving abiraterone and enzalutamide: A nationwide retrospective cohort study. Presented at: ASCO GU 2022; February 17-19, 2022; Abstract 50.