JAMA Oncology has published a new study that suggests that adding a statin drug at the initiation of hormone therapy (ADT) to the treatment protocol for a man with progressive, hormone-sensitive prostate cancer may significantly impact their actual time to disease progression (TTP).
Historically, we know Statin use has been associated with improved prostate cancer outcomes. It is believed that the biology behind the positive effect of statin drugs is directly related to the fact that Dehydroepiandrosterone sulfate (DHEAS) is a precursor of testosterone (which feeds prostate cancer) and a substrate for SLCO2B1, an organic anionic transporter (moving substances into the cell).
Additionally, it has been shown that genetic variants of SLCO2B1 correlate with time to progression (TTP) dwhile men have androgen deprivation therapy (ADT). Statin drugs also use the anionic transporter SLCO2B1 to enter cells, and thus may compete with DHEAS uptake by the tumor cells, limiting their androgen uptake.
The researchers retrospectively analyzed 926 men who were hormone sensitive and who had received ADT for biochemical or metastatic recurrence.
The first determined whether statins interfere with DHEAS uptake. Then they queried their institutional clinical database to assess for an association between statin use and TTP during ADT using multi-variable Cox regression analysis and adjusted for known prognostic factors.
They confirmed that statins did block DHEAS uptake by competitively binding to SLCO2B1 inn the ADT cohort of men taking a statin at ADT initiation.