MedicalResearch.com: What are the main findings of the study?
Dr. Azoulay: Using large population-based databases from the UK, we assembled a cohort of men newly-diagnosed with non-metastatic prostate cancer. Within this group of men, the use of statins after prostate cancer diagnosis was associated with a 24% decreased risk in cancer-related mortality. We observed duration- as well as a dose-response relationships. Furthermore, in a secondary analysis, we observed that the benefits were greater among men who used also used statins before their diagnosis, with more modest yet significant benefits among men who initiated the treatment after their diagnosis. The latter result is one of the novelties of this study, as it provides an estimate of the potential benefits of statins, if used in the adjuvant setting.
Several studies have previously associated the use of statins with a decreased risk of certain prostate cancer outcomes, such as biochemical recurrence. Few however, have investigated the relationship with cancer-related mortality, which is the outcome of interest for men with prostate cancer. Thus, our study provides novel information with respect to this outcome, and avoided several important methodological shortcomings of the previous studies.
The results of this study are promising, and if confirmed in other well-conducted observational studies and clinical trials, statins may be considered as a prostate cancer treatment. However, for the time being, statins should be reserved for men who need to control their cholesterol levels and not for the sole purpose of improving prostate cancer prognosis. Additional studies are needed before adding prostate cancer as a new statin indication.
Methodologically-sound studies are needed to confirm our results. These studies should also try to identify the subgroups of patients most likely from statin therapy. For example, would the treatment work equally among men who underwent a radical prostatectomy vs radiation therapy? These are important questions that need to be answered, and which could help guide the design of randomized clinical trials assessing the efficacy of statins on prostate cancer outcomes.
Use of Statins and the Risk of Death in Patients With Prostate Cancer
Oriana Yu, Maria Eberg, Serge Benayoun, Armen Aprikian, Gerald Batist, Samy Suissa, and Laurent Azoulay
JCO.2013.49.4757; published online on November 4, 2013;